Active Lifestyle Awards nomination form

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General criteria for all awards
• The deadline for making nominations is on
Tuesday 5 May 2015 by 5pm.
• You must give details and evidence of the
criteria elements in your nomination.
• You must give details and evidence for as
many of the criteria within that category in
your nomination but please limit the amount of
supporting information in your nomination to
no more than 300 words. Please use bullet
points, paragraphs or headings where
possible to describe how each point has been
met.
• Those making nominations may be contacted
by the Awards Panel to obtain further
information about the nominee.
• The nomination eligibility criteria period apart
from Outstanding Contribution, is from 1 May
2014 – 30 April 2015.
• All nominees should be active in Telford and
Wrekin.
• Nominations can be individuals, clubs,
organisations, companies, projects or
partnerships depending on the individual
award criteria.
• You can make as many nominations in each
category as you wish, although you must use
separate forms.
• All nominations will be assessed by an Awards
Panel and a shortlist of three candidates for
each award category will be selected.
• Self nominations are acceptable.
• The panel can only base their decision on the
information in the nomination form which needs
to be completed in no more than 300 words.
• The decision of the awards panel is final and
no correspondence will be entered into.
Individual Award Categories and
Criteria
Coach of the Year
This award recognises the achievements of a
paid or unpaid coach who has made a significant
impact on those they have coached and is
committed to providing more opportunities for
people to start, stay and succeed in sport. The
criteria are:
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Nominee is a qualified coach (paid or unpaid)
who has made a significant contribution to
others through their coaching.
Contribution of coach to encourage more
people to start, stay or succeed in sport and
physical activity.
Widening access to sport and physical activity
through high quality coaching and innovative
practices.
An inspiration and positive role model for
participants and their peers.
Amount of time committed to coaching per
week.
Be qualified and committed to continued
professional development.
Has built strong relationships and links with
clubs, schools and/or other community
organisations.
Has special qualities and key achievements
over the past twelve months that sets them
apart from others.
Volunteer of the Year
 Commitment to improving the standard of their
This award recognises those who give up their
volunteering through undertaking sports
time for free and by doing so make participating
courses.
in sport possible in their club. This category aims  Has special qualities and key achievements
to recognise the wide variety of roles that
over the past 12months that sets them apart
from others.
volunteers perform, from club secretaries and
treasurers to grounds keepers and fundraisers.
Sport Makers can also apply in this category.
Sports Performance of the Year
Please nominate unpaid coaches for the Coach
This award recognises a person or team (able
of the Year award. The criteria are:
bodied or disabled) who has excelled in their
 Nominee has made a positive impact on
sport and is a positive role model to others. The
others through their giving their time for free in criteria are:
sport and physical activity.
 Contribution of volunteer to encourage more
 Nominee(s) must be aged 18 years or over on
people to start, stay or succeed in sport and
30 April 2015
physical activity.
 A sports man or woman, or a team of sports
 Committed considerable time to their
men or women who have excelled in their
volunteering.
chosen sport. Rankings and achievements
 Widening access to sport and physical activity
made during the eligibility period must be
through their volunteering.
given.
 An inspiration and positive role model for
 Have demonstrated considerable
participants and their peers.
commitment.
 Has built strong relationships and links with
 Are an inspiration and positive role model to
clubs, schools and/or other community
others.
organisations.
 Have used their achievements and
 Has special qualities and key achievements
experiences to make a positive impact on their
over the last twelve months that sets them
community and /or club.
apart from others.
 Has special qualities and key achievements
over the past twelve months that sets them
Young Volunteer of the Year
apart from others.
This award recognises a young person who
gives up their free time to encourage others to
take part in sport. They will be a positive role
model for other young people and be committed
to their own personal development. Sport Makers
aged 21 or under can also apply in this category.
The criteria are:
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Nominee must be aged 21 years or under on
30 April 2015
Demonstrated exceptional leadership skills.
An inspiration and positive role model for other
young people, acting in a responsible and
professional manner.
Has demonstrated a significant contribution to
sport in their community, contributing at
minimum of 25 hours of volunteer time in
during the eligibility period.
Junior Sports Performance of the Year
This award recognises a young person or team
(able bodied or disabled) who has excelled in
their sport and is a positive role model to others.
The criteria are:
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Nominee(s) must be under 18 years of age on
30 April 2015
A sports man or woman, or a team of sports
men or women who have excelled in their
chosen sport. Rankings and achievements
made during the eligibility period must be
given.
Have demonstrated considerable
commitment.
Are an inspiration and positive role model to
others.
Have used their achievements and
experiences to make a positive impact on their
community and /or club.
Special qualities that set them apart from
others.
Community Club of the Year
This award recognises a community sports club
that provides a high quality sports environment
for its members. The club will have achieved this
through supporting coaches and volunteers and
developing the infrastructure of the club in order
to benefit members. The criteria are:
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Is committed to the long-term development of
their club, for example, has put in place a club
infrastructure which will sustain the club in the
future, trying to ensure members can
participate at good quality facilities etc.
Has widened access to their sport to include
people who do not normally have the
opportunity to take part / targeted work at
engaging people from ‘hard to reach’ groups*)
Has special qualities and key achievements
over the past twelve months that sets them
apart from others.
*Hard to reach groups include: women and girls,
disabled people, older people, people from black
and ethnic minority communities and people on
lower incomes.
Newcomer Award – Individual
This award recognises the achievements of an
individual in their first 12 months of participating
in their chosen sport, activity or role. The
individual should have made an outstanding and
inspirational contribution, above and beyond that
normally expected for someone in their first 18
months. The criteria are:
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Committed to raising standards and have
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achieved (or at least be working towards)
Clubmark or an equivalent quality mark or
affiliation.
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Engaged with the local community.
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Actively encouraging members to start, stay
and succeed in sport.
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Can demonstrate commitment to the
development of the members of their club,
including participants, coaches and
volunteers.
Has built strong links with schools and other
community organisations in order to engage
with young people (if relevant i.e. the club has
a junior section).
Developed an effective management
structure.
They should be active in Telford and Wrekin
Going above and beyond what would normally
be expected in the first 18 months of an
athlete, official, coach or volunteer
An individual that has made an exceptional
contribution/had a significant impact in the
local community
An inspiration/role model for others
Must be new to the sport/activity within the last
12 months leading up to 30 April 2015
Newcomer Of The Year – Team or Club
This award recognises the achievement of a club
or team in their first year of participation in their
chosen sport, activity or role. The club or team
should have made an outstanding and
inspirational contribution, above and beyond that
normally expected of a club or team within their
first year and should be active within Telford and
Wrekin. The criteria are:
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Going above and beyond what would normally
be expected of a first year club or team
An club or team that has made an exceptional
contribution / had a significant impact in the
local community.
An inspiration/role model for others.
Must be new to the sport/activity from April
2014
Active Lifestyle Award – Individual
This award recognises an individual who has
made a dramatic lifestyle change to become
more physically active and has greatly improved
their health as a result. In addition to undertaking
more physical activity or sport the improvement
in health could be coupled with other healthy
lifestyle choices such as healthy eating or giving
up smoking. The criteria are:
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An individual who have made a significant
improvement to their health by becoming
more physically active.
An inspiration and positive role model to
others.
Special qualities that set them apart from
others
Community Project Of The Year
This award recognises an innovative project
which uses sport and physical activity to improve
and enhance the quality of life of the people in
Telford and Wrekin’s communities. Examples of
projects could include Sportivate projects or
Community Games events. The criteria are:
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A project that has made a significant
contribution to overcoming barriers in the
participation of sport and physical activity in
the geographical area Telford and Wrekin.
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Effectiveness at creating new opportunities for
more people, particularly ‘hard to reach’
groups to start, stay or succeed in sport and
physical activity.
Evidence of encouraging a community to lead
more active and healthy lifestyles.
Evidence of how innovative ideas have been
used to promote, develop or enhance
participation in sport and physical activity.
Has built strong community relationships and
links.
Dedication and commitment from those
involved.
An inspiration and example of best practice for
others.
Special qualities that set the project / team
apart from others.
Employer of the Year
This award recognises a local employer that
actively encourages and enables their workforce
to be more physically active and lead a healthier
lifestyle. They may also support community
sport, for example sponsoring a local club or
encouraging their workforce to volunteer in
sporting environments. The criteria are:
 Evidence of encouraging their workforce
to lead a more physically active and
healthy lifestyle.
 Demonstrate commitment to helping their
workforce be more active (e.g. installing
bicycle racks and showers for those who
wish to cycle to work).
 Demonstates at least one of the following:
o Supports local community sport, for
example through sponsorship.
o Encourages their workforce to
volunteer in local community sport
settings or at community sport
events, and evidence of workforce
achievments.
 Has special qualities and key
achievements over the past twelve
months that sets them apart from others.
 Company size will be taken into account
when assessing nominations.
Award for Outstanding Contribution to Sport
and Physical Activity
This special award recognises an individual who
has made an outstanding contribution to sport
and physical activity in Telford and Wrekin over a
number of years. The criteria are:
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An individual that has made an exceptional
contribution to increasing participation in sport
and physical activity in Telford and Wrekin.
Achieving against the odds.
Gone above and beyond the call of duty.
A role model for others.
Involvement in sport and physical activity over
a number of years.
Special qualities that set them apart from
others.
Details of person/scheme being nominated
Tick below the category of your nomination. We would encourage you to use a separate form
for each nomination. This is because the criteria for each category is different, and you have a
limited word count to explain the reason for your nomination.
Coach of the Year
Volunteer of the Year
Young Volunteer of the Year
Sports Performance of the Year
Junior Sports Performance of the Year
Community Club of the Year
Newcomer of the Year - Individual
Newcomer of the Year – Team/Club
Active Lifestyle of the Year - Individual
Community Project of the Year
Employer of the Year
Outstanding Contribution Award
Title (Mr/Mrs/Miss etc):
Forename:
Surname:
Club/Company:
Address:
Post Code:
Telephone:
Mobile:
Email:
Age of nominee where applicable on 30 April 2015:
(Please check if there is age criteria in the category you are nominating to ensure that the person you
are nominating is eligible.)
Is the person/group(s)/organisation aware that you have nominated them?
Yes
No
Reason for nomination
Please provide not more than 300 words – (words after this number will regrettably not be
taken into account) and include the following:
 Information/evidence against the criteria for the category chosen
 Your nomination covers the specific criteria in numerical order
 Facts and figures to support your nomination (e.g. coaching hours, length of time the person or
project has been successful)
 Explain what makes this person, club or project so special
The Awards Panel will only review the details presented. This is your opportunity to promote the
value of the nominee’s achievements.
Please write here (Field will expand as you type. If you are submitting your nomination via post
please attach your statement to this form.):
Please provide a recent photograph of the individual/group/project. If possible, please make it
an action shot or a photo that shows the person or project in the relevant activity or environment.
(Photographs can be returned if requested)
The photograph can be emailed to sportsdevelopment@telford.gov.uk or attached to this nomination
form. Please do not staple photos.
Your details
Title (Mr/Mrs/Miss etc):
Forename:
Surname:
Address:
Post Code:
Telephone:
Mobile:
Email:
Please state your relationship with the nominated person (e.g. family, coach, teacher etc.):
Are you happy for a press release to be issued by Telford & Wrekin Council using the above
information?
Yes
No
If you are applying for Employer of the Year please complete the following:
Please state your position within the company:
Small (less than 10 employees)
Medium (up to 50 employees)
Large (over 50 employees)
Your signature:
If your nomination is shortlisted, they will be invited to attend the Active Lifestyles Awards evening on
Wednesday 8 July. Regrettably, due to limited capacity at the Place, Oakengates, only those
shortlisted can be invited to our Awards Evening. We will contact all nominees to advise them
whether they have been short listed or not in the week commencing Monday 15 June 2015.
Please return the completed nomination form to:
Sports Development
Leisure Services,
Wellington Civic & Leisure Centre
Larkin Way
Off Tan Bank
Wellington
Telford
TF1 1LX
Email to: sportsdevelopment@telford.gov.uk
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