Name of Applicant

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* 1. Name of Applicant

Referee's Details

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* 2. Referee's Details

I confirm that I know this representative/organisation and their work for Sport in the City of Worcester. I have read this application and support the request for award. I would be willing to talk about the benefit of any successful award to the representative/organisation and provide a brief written report if required.
Supporting Statement

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* 3. Supporting Statement

Declaration

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* 4. Declaration

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