Junior or Senior Sportsperson of the Month Nomination Form
A Junior Nominee is a sportsperson who is 16 Years of age (in the current year) or younger and resides, or is a member of a sporting organisation, that is located within the Penrith Local Government Area.
A Senior Nominee is a sportsperson who is over the age of 16 and resides, or is a member of a sporting organisation, that is located within the Penrith Local Government Area.
Email address *
Which Award are you Nominating for *
2020 to 2021 Nomination for the month of *
Name of Nominee *
Nominee's Date of Birth *
Nominee"s Address *
Nominee's Contact Number 1 *
Nominee's Contact Number 2
Details of Nominee *
e.g. where nominee plays / competes, length of time in sport, history of achievements etc
Details of Nominee's Most Recent Meritorious Achievement *
Nominators Name *
Relation to Nominee / Position in Organisation *
Nominators Contact Number *
Nominators Email Address *
Disclaimer *
I give permission for Penrith Valley Sports Foundation, it's affiliated sponsors, Penrith City Council, Nepean News and other local media to use this information and any photography/Video material supplied, if successful, to be used on all their relevant Social Media Pages and Websites.
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