Nomination Form - Individual

I understand the shortlist panel can only take into consideration and therefore make their decision based on the information provided on this application only.

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* 1. Please select one of the following:-

1. Sports Personality of the Year

2. Young Sportsman of the Year

3. Young Sportswoman of the Year

4. Disabled Sportsperson of the Year

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* 2. Nominee Details

Name of nominee

Club

Sport

Address

Postcode

Phone Number

School/Occupation

Age

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* 3. Nominator Details

Name

Address

Postcode

Phone Number

Capacity in which nominee is known to you

Supporting Details
Please list the nominee's top three achievements from Sept 2019 to August 2021

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* 4. Achievement 1

Name of Competition

Position (e.g 1st, 2nd 3rd)

Date of Competition

Venue of Competition

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* 5. Achievement 2

Name of Competition

Position (e.g 1st, 2nd 3rd)

Date of Competition

Venue of Competition

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* 6. Achievement 3

Name of Competition

Position (e.g 1st, 2nd 3rd)

Date of Competition

Venue of Competition

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* 7. Has the nominee been selected to represent their sport at a National and/or International level from Sept 2019 to August 2021? If so, please provide details.

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* 8. Does the nominee have a Welsh/British Ranking?

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* 9. Has the nominee overcome adversity during the COVID-19 Pandemic to also inspire others? If so, please explain. (We are looking for individuals who have used their position/status within their sport to inspire others to continue to be active during the pandemic. This could be setting challenges for others, showcasing how they continued to be active)

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* 10. Please use this section to provide further details on why you think your nomination is worthy of winning the award.

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* 11. I confirm that the information given is correct, to the best of my knowledge

I confirm

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* 12. I am happy for the information on this nomination form to be used in any publicity for the award, eg, press notices, social media, websites

Yes