RISING SPORTS STAR

Athlete's name:*
First NameLast Name
Date of Birth:*
DayMonthYear
Date
Date of nomination:*
DayMonthYear
Date
Sport:*
Athlete's email address:
example@example.com
Athlete's mobile no:
Area CodePhone Number
Residential Address:*
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Postal address (if different from above):
Street Address
Street Address Line 2
CityState / Province
Postal / Zip Code
Parent's name:*
First NameLast Name
Parent's email address:*
example@example.com
Parent's mobile no:*
Area CodePhone Number
Club or school contact:*
First NameLast Name
Club or school contact email address:*
example@example.com
Club or school contact mobile no:*
Area CodePhone Number
Criteria:
1. Nominees to be aged between 13 and 18 years of age between the dates of 1st July 2019 to 30th June 2020
2. Nominees to reside within the boundaries of the Busselton shire
3. Nominees must be involved in their nominated sport within the Shire of Busselton as either a Player, Coach, Umpire and/or volunteer.
4. Nominees can apply more than once but only if they have not received a Winner or Runner-up award in the previous year

Sporting achievements