Online Nomination Form – Service to Masters

Nominating club *

(Only nominations submitted by Clubs will be considered. Nominations submitted by individuals will not be accepted)

Nominee's name *

First

Last

Nominee's address *

Suburb *

Postcode *

Mobile number *

Landline number

Nominee's email *

Nominator's name *

First

Last

Mobile number *

Landline number

Nominator's email *

Please list the Nominee’s contributions to the Masters community during the year nominated. *

Please describe how the Nominee’s contributions have made an impact to Masters squash. *

Checklist – please tick *

The Nominee is a financial member of your Club.
You have provided personal details including contact information of the Nominee.
You have provided personal details including contact information of the Nominator.
You have considered how the Nominee’s achievement have benefited not only your Club but also the wider squash community.
The Nominee is aware they are being nominated so they can make arrangements to attend the WA Squash Awards Night.

Has the Nominee been nominated for this award before? *

Has the Nominee won this or any other WA Squash award before? *