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* 1. What is your name and TI Number:

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* 2. Name the coach you would like to nominate.

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* 3. How would you describe their contribution to their club? Please write a couple of lines to support the impact on their club below. 

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* 4. How would you describe their commitment to their self development?

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* 5. How would you describe their awareness of their duty of care as a coach in terms of safety and safeguarding?

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* 6. How would you rate their their effectiveness as a coach and how it has effected you personally?

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* 7. Is there anything else you would like to say about your nominee?

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