Town of Port Hedland & BHP Community Sports Awards 2024 Nomination Form

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Nominator Details (Your Details)

Name*

Phone Number*

Email Address*

Nomination Category

Please select the category you wish to nominate for.*

Click here[PDF 600 KB] to download a copy of the full eligibility criteria for all award category

Sporting Group of the Year

Awarded to an organisation who has demonstrated outstanding work and contribution to the Pilbara sporting community in the areas of organisational development, people development and participation within their chosen sport.

Club / Association*

Club Contact Full Name*

Club Contact Number or Email*

Participation and attendance at a minimum of one Every Club workshop or Town of Port Hedland lead Club development workshop, consultation and/or event initiative in 2024.*

YesNo

Has the club/association increased or maintained if level of service and memberships from the previous year?*

YesNo

Provide evident details on how the club/association demonstrates appropriate levels of ‘best practice’ surrounding club governance and management.*

Can the club demonstrate sound financial management?*

YesNo

Junior Sportswoman of the Year

Awarded to an individual whom has achieved outstanding success in their sport.

Nominees Full Name*

Is your Nominee under the age of 18 as of Sept 2024 and resides in Port Hedland*

YesNo

Nominees Contact Number or Email*

Club / Association*

Selected/and or competed at Nortwest Country State National and / or International Championship*

YesNo

Not been suspended, disciplines or reprimanded at any level of competition*

YesNo

Explain how the individual has displayed and demonstrated high level of sportsmanship and commitment to personal development and teamwork within their chosen sport.*

Sportswoman of the Year

Awarded to an individual whom has achieved outstanding success in their sport.

Nominees Full Name*

Is your Nominee over the age of 18 as of Sept 2024 and resides in Port Hedland*

YesNo

Nominees Contact Number or Email*

Club / Association*

Selected/and or completed at NorthWest Country State national and / or international Championship.*

YesNo

Not been suspended, disciplines or reprimanded at any level of competition*

YesNo

Explain how the individual has displayed and demonstrated high level of sportsmanship and commitment to personal development and teamwork within their chosen sport.*

Umpire/Official of the Year

Awarded to an individual who displays strength and character and/or provided considerable achievement, support to the development of individuals/teams in their chosen sport

Nominees Full Name*

Nominees Contact Number or Email*

Club / Association*

Provide details on the nominee’s official capacity at sporting fixtures or events at a Local, Regional or State Level in 2024.*

Has the nominee completed a Level 1 National Accredited course relevant to their chosen sport/s?*

YesNo

How has the nominee demonstrated commitment and contribution to their personal development, along with the development of their sport in 2024?*

Explain how their leadership has improved the level of performance of the team/individual.*

Coach of the Year

Awarded to an individual who displays strength and character and/or provided considerable achievement, support to the development of individuals/teams in their chosen sport.

Nominees Full Name*

Nominees Contact Number or Email*

Club / Association*

Provide details on the nominee’s official coaching capacity at sporting fixtures or events at a Local, Regional or State Level.*

Has the nominee completed a Level 1 National Accredited course relevant to their chosen sport/s?*

YesNo

How has the nominee demonstrated commitment and contribution to their personal development, along with the development of their sport in 2024?*

Explain how their coaching leadership has improved the level of performance of the team/individual.*

Volunteer of the Year

Awarded to an individual who has displayed outstanding conduct as a volunteer in the support, administration and delivery of services to the sport within the Pilbara region.

Nominees Full Name*

Nominees Contact Number or Email*

Club / Association*

Please provide information based on the nominee's role in the club/association during 2024? How have they assisted with the club/associations program and service delivery?*

Please outline the nominee's contribution to the club’s objectives and the Town community through their sport (commitment to their club / association group, mentor, coaching etc.).*

Participation and attendance at a minimum of one Every Club workshop or TOPH lead Club development workshop, consultation and/or event initiative in 2024.*

YesNo

Did the person receive remuneration for their service to the club/association?*

YesNo

Service to Sport

Awarded to an individual whom has made significant and sustained contributions to the sporting community over a long period.

Nominees Full Name*

Nominees Contact Number or Email*

Club / Association*

Provide the nominees length of service to sporting club/associations within the community (minimum 10 years).*

Please provide the number of sporting clubs/associations the nominee has engaged with over time.*

Demonstrate how the nominee has contributed to the sport/s club/association.*

Outline achievement or legacy reward the nominee has received as a result of their contribution to their club/association.*

Junior Sportsman of the Year

Awarded to an individual whom has achieved outstanding success in their sport.

Nominees Full Name*

Is your Nominee under the age of 18 as of Sept 2024 and resides in Port Hedland*

YesNo

Nominees Contact Number or Email*

Club / Association*

Selected/and or completed at NorthWest Country State national and / or international Championship.*

YesNo

Not been suspended, disciplines or reprimanded at any level of competition*

YesNo

Explain how the individual has displayed and demonstrated high level of sportsmanship and commitment to personal development and teamwork within their chosen sport.*

Sportsman of the Year

Awarded to an individual whom has achieved outstanding success in their sport.

Nominees Full Name*

Is your Nominee over the age of 18 as of Sept 2024*

YesNo

Nominees Contact Number or Email*

Club / Association*

Selected/and or completed at NorthWest Country State national and / or international Championship.*

YesNo

Not been suspended, disciplines or reprimanded at any level of competition*

YesNo

Explain how the individual has displayed and demonstrated high level of sportsmanship and commitment to personal development and teamwork within their chosen sport.*

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