Sport Waikato

Nomination Category*

First Name

Last Name

Email Address*

School

Postal Address 1*

Postal Address 2

Town*

District*

Waikato District includes Ngaruawahia, Huntly, Raglan, Matangi, Tamahere, Te Kauwhata, Meremere, Pokeno, Tuakau and Port Waikato

Postcode*

Phone/Mobile Number*

Club/Organisation

Sport*

Disability/Para sport

YesNo

Gender

First Name of Nominator*

Last Name of Nominator*

Phone/Mobile Number*

Postal Address 1*

Postal Address 2

Town*

Postcode of Nominator*

Nominator Email Address*

Photo Upload 1

Photo Upload 2

Disclaimer*

I have been authorised by the club/organisation to make this nomination. I agree to all the criteria and confirm the information I am providing in this nomination form is factual and submitted as a true reflection of the nominee’s achievements. Where the nominator is a caregiver/parent/relative of the nominee, Sport Waikato reserves the right to contact the sport club/organisation directly for further information on said nominee and their achievements.

Keep your details and nominate again?

Check this box if you want to keep your details for next nomination.

Waikato District includes Ngaruawahia, Huntly, Raglan, Matangi, Tamahere, Te Kauwhata, Meremere, Pokeno, Tuakau and Port Waikato

Sport Waikato Staff Portal