2023 Football West Community Football Awards - Forms

"*" indicates required fields

Nominators Full Name*

First Name Last Name

Nominators Email*

Nominators Mobile Number*

Awards Category*

Are you submitting a self-nomination or nominating someone else?*

Someone else

Self-nomination

Name of the organisation/group/individual being nominated*

Address

Street Address Street Address Line 2 City State / Province Postal / Zip Code

Nominee Email (or best contact)*

Nominee Mobile Number (or best contact)*

Please provide a brief summary of the Nominee*

Demonstrated excellence in the nominated award category?*

Created sustainable participation in football and ensured a high-quality experience for everyone?*

Shown a firm commitment to inclusion by ensuring that football is a sport for All Australians including Indigenous, Multicultural, All Abilities, Women and Girls, LGBTIQ+ and many more?*

Please upload a photo relating to the nomination

Please note that by submitting a photo you give Football West permission to use the photo in promotional materials associated with the Awards.

Upload second photo (if desired)

Upload third photo (if desired)

Upload fourth photo (if desired)

Please provide a brief description of the photos provided.