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2017 Basketball Victoria Country Annual Award Nomination Form

Please complete all requested information.

Nominations close: 15th December, 2017

Question Title

* Summary information:

Your Full Name:

Your Basketball Association:

Name of the Person/Association/Program you are nominating:

Question Title

* I am nominating the above named for the following Award (please select one):

Kristi Harrower Award - Junior Female Athlete of the Year

Ray Borner Award - Junior Male Athlete of the Year

Cheryl Creighton Award - Female Coach of the Year

Owen Hughan Award - Male Coach of the Year

Judy Doye Award - Female Administrator of the Year

Ashley Donaldson Award - Male Administrator of the Year

Bev Bauer Award - Female Volunteer of the Year

Ross Birthisel Award - Male Volunteer of the Year

Award for Outstanding Achievement by a Large Association

Keith Wilson Award - Outstanding Achievement by a Small Association

Bob Osborne Award - Outstanding Contribution by a Female to Diverisity and Inclusion

Garry Bird Award - Outstanding Contribution by a Male to Diversity and Inclusion

Bill McCarthy Award - Outstanding Promotion of Basketball

John Holden Award - Outstanding Development of Referees at a Large Association

Noel Byers Award - Outstanding Development of Referees at a Small Association

Dennis Morgan Award - Outstanding Achievement by a Junior Female Referee

Terry Davis Award - Outstanding Achievement by a Junior Male Referee

Helen Pawsey Award - Outstanding Achievement by a Female Referee

Rod Bush Award - Outstanding Achievement by a Male Referee

Jack Terrill Award

Question Title

* Contact details of person completing this form:

Full Name

Postal Address

Suburb/Town

State

Post Code

Email Address

Phone Number (mobile or landline)

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* Achievements:
Please list the top three (3) achievements that are relevant for this award:

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* Worthiness:
Please list up to three (3) reasons this person/association/program is a worthy recipient:

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* Additional supporting information (may include other awards won):

Please review all information provided and then submit your nomination:

Question Title

* Summary information:

Question Title

* I am nominating the above named for the following Award (please select one):

Question Title

* Contact details of person completing this form:

Question Title

* Achievements: Please list the top three (3) achievements that are relevant for this award:

Question Title

* Worthiness:Please list up to three (3) reasons this person/association/program is a worthy recipient:

Question Title

* Additional supporting information (may include other awards won):

* Achievements:
Please list the top three (3) achievements that are relevant for this award:

* Worthiness:
Please list up to three (3) reasons this person/association/program is a worthy recipient: