Contribution to Sport

To qualify for this award the individual nominee must meet ONE of the following Qualification Criteria:

• Been born in County Durham
• Currently live in County Durham
• Play or have played for a County Durham team
• Coached or volunteered in County Durham
• Be able to show a significant connection to County Durham

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

• Competed at a National level in their chosen sport
• Shown a long term commitment to volunteering in sport in County Durham
• Coached athletes up to a National/International level
• Made a significant difference to individuals/groups through sport in County Durham

PLEASE NOTE: If you wish to save your form to complete at a later date, you must ensure you make note of the reference number given when clicking 'Save for later...' as you will be required to enter this when clicking 'Load...' to access the data.

Nomination Details   CSN are for which the nomination is being made. Please select the appropriate box (ONE box only)   Chester le Street and Durham City Easington Teesdale and Wear Valley Derwentside Sedgefield   Name of Nominee (person you are nominating)     Address (must be provided to allow contact)     Telephone (if known - important to allow contact)     Email Address (if known)   Reason for Nomination Please give details of the reason you are nominating this individual, 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 (your name)     Telephone number     Email Address   Image   Please upload an image of the group/individual (for use in presentations)     Is the nominated person aware of this nomination?   Yes No      I nominate the above group/individual and confirm to the best of my knowledge the details given in support of this nomination are accurate. I understand the judges' decision is final and that no correspondence will be entered into. * If any of the details are found to be inaccurate or false this will result in your nomination being withdrawn from the process.   Type both words separated by a space below:

Developed by BinaryFold4