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UNIVERSITY OF ESSEX SPORTS AWARDS 2011-12 EXCEPTIONAL SERVICES TO SPORT AWARD NOMINATION FORM (To be returned by e-mail by Friday 02/03/2012) If you wish to apply for Full Colours, then you must also fill out the Full Colours nomination form This award is to acknowledge consistent service to one or more club(s), to the Sports Federation or simply to Sport at Essex beyond that which is normally expected of a club member, student or official. It should be stressed that the award is for someone who has made an outstanding contribution and not just someone who has done a good job. Please provide as much information as possible to support your application. Please do not write long paragraphs – use bullet point answers NOMINEE: STUDENT/REG NO:

COURSE:

YEAR:

MAIN SPORT/S 1.

SPORTS CLUB CONTRIBUTION Outline details of Sports Clubs represented during your time at University of Essex.

2.

SPORT/TEAM

20

-

20

SPORT/TEAM

20

-

20

SPORT/TEAM

20

-

20

SPORT/TEAM

20 (I.e. 2009 -

20 2010)

CLUB OFFICIAL POSITIONS HELD

Include any details of contribution made in position that you feel is relevant to the nomination. CLUB: CONTRIBUTION: CLUB: CONTRIBUTION: 3.

POSITION HELD:

POSITION HELD:

DATE:

DATE:

OTHER POSITIONS HELD Eg, Sports Federation Executive or Finance Committee

POSITION HELD: CONTRIBUTION:

DATE:

POSITION HELD: CONTRIBUTION:

DATE:

4

INTERNAL EVENTS Please give details of any internal sports competitions or Sports Federation events that you have taken part in whilst at the university.

(INSERT INFORMATION HERE – PLEASE FEEL FREE TO USE MORE SPACE)


5

OTHER CONTRIBUTIONS MADE Please list any other contributions to sport at the university that you feel would support your nomination. This would include details of events that you have organised, minibus driving for other teams, charity work, sports federation administration etc,

(INSERT INFORMATION HERE – PLEASE FEEL FREE TO USE MORE SPACE)

Note - Having completed the individual sections of the form please e-mail this to your relevant club president or captain for completion and submission. Applications made directly from applicants themselves will not be accepted. All applications must then be compiled by the club president or captain in electronic form and forwarded as one e-mail with the club’s Full Colours nominations to vpactivities@essex.ac.uk with “[club name]’s sports nominations” as the subject heading. No paper or hard copies will be accepted.

FOR CLUB USE ONLY (TREATED IN CONFIDENCE) 6. PRESIDENT’S/CAPTAINS (or other club official’s) REFERENCE (Comments will be confidential – please give as much relevant information as possible in support of the individual concerned with this nomination) (PRESIDENT/CAPTAIN TO INSERT INFORMATION HERE – PLEASE FEEL FREE TO USE MORE SPACE) I acknowledge to the best of my knowledge that this is a true and accurate representation of the applicant’s achievements. I understand that if this is not the case, then my own eligibility for sports awards is jeopardised. NAME: (On behalf of the club)

POSITION IN CLUB:

This application has been checked and countersigned by a Sports Federation Executive Committee Member prior to being submitted to the Sports Advisory Group. SIGNED: _________________________ TITLE: _________ (On behalf of the Sports Federation) FOR SAG USE ONLY This application, having first been ratified by the relevant club Committee, is to be submitted to the Sports Federation who will verify the details, and who will forward the application to the Sports Advisory Group for approval whose decision is FINAL. AWARDED/NOT AWARDED

Signed___________________________ Chairman of Sports Awards Group

Date____________

NOMINATIONS MADE AFTER CLOSING DATE (02/03/2012) WILL NOT BE CONSIDERED


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