Contribution to Physical Activity

To qualify for this award, the individual or group of must meet ONE of the following Qualification Criteria:

• Be born, live in and/or be based in County Durham
• Be able to show a significant connection to County Durham

To qualify for this award the individual or group must ALSO meet ONE of the following Nomination Criteria:

• Shown a long term commitment to developing physical activity opportunities in County Durham
• Made a significant difference to individuals/groups through physical activity in County Durham
• Demonstrated the positive impact physical activity can have on people's lives

Name of Nominee (individual or group)     Address (if known)     Telephone (if known)     Email Address (if known)     Reason for nomination. Please give details of the reason you are nominating this individual or group, highlighting how they specifically meet one/some/all elements of the Qualification and Nomination criteria in no more than 250 words   Details of person making the nomination   Name     Contact telephone number     Contact email address     Is the nominated person/group aware of this nomination?   Yes No      I nominate the above individual/group and confirm to the best of my knowledge the details given in support of this nomination are accurate *

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