ACTIVE YORK SPORTS AWARDS 2015 NOMINATION FORM NOMINEE DETAILS (Please complete in BLOCK CAPITALS) Name of Nominee_______________________________ _____ Home Address of Nominee_____________________________ __________________________________________________ Postcode_____________________________ ______________ Telephone Number_________________________________ __ Email address______________________________ _________ Gender___________________________ ________________ Date of Birth (categories marked * only)___________________ Sport or Activity of Nominee____________________________ Club/Sport/Association _______________________________ Parent/Guardian name (categories marked * only) __ ________________________________________________ Parent/Guardian contact details (categories marked * only) ___________________________________________________________________________ NOMINATOR’S DETAILS (Please complete in BLOCK CAPITALS) Name of Nominator____________________________________ Home Address of Nominator____________________________ ___________________________________________________ Postcode___________________________________________ Nomination for Active York Sports Awards 2015 DATE: Saturday 18 April 2015 VENUE : Roger Kirk Centre, University of York Category for nomination please tick one box Young Male Sportsperson of the Year* (under 18) Young Female Sportsperson of the Year* (under 18) Telephone Number____________________________________ Email address________________________________________ Nominator’s relationship to Nominee (eg Club Secretary/Coach/Manager) ______________________ Citation (Please state why you believe this individual/group should receive an award. If you wish to submit additional information please limit this to one TYPED side of A4 paper) _______________________________________________ ______________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ ______________________________________________________________________________ Young Disabled Sportsperson of the Year* (under 18) Team/Club Award of the Year Student Sportsperson of the Year (16+) Sportsman of the Year Sportswoman of the Year Disabled Sportsperson of the Year Active in York Award Coach of the Year Volunteer of the Year Active School of the Year Active Workplace of the Year Outstanding Contribution to Sport Award Please return completed nomination forms by 12noon on Thursday 26 March 2015 to: naomi.lee@york.gov.uk or to Naomi Lee, Active York, West Offices, Station Rise, YORK, YO1 6GA. For further information please contact Naomi on 07554 334835 or 01904 553377.