UNIVERSITY OF CANTERBURY BLUES
2013 APPLICATION FORM
For achievements September 2012 to September 2013
A University Blue finds its origins in the sporting rivalry, initially in rowing, between the universities of Oxford
and Cambridge. Awarded since the early 1800s, a Blue is coveted and prestigious recognition of outstanding
student-athletes. At the University of Canterbury, the Blue has been awarded since the early 1900s making this
year’s awards the Centennial celebration.
Complete this form in block letters. Nomination Deadline: FRIDAY 30th AUGUST 5pm.
Please ensure all sections are completed.
NOTE FOR APPLICANTS: To be eligible for a UC Blue, students must:
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Be enrolled at UC or have graduated one year prior to the presentation of the award
Have paid student association/university fees
Where possible be a competing member of a university club
In addition students must pass at least one third of a full-time course at University.
Representing Age Group: please circle 18-20
20-29
Senior/Open
Sport: .......................................................................................................................................................................
First Name(s): ..........................................................................................................................................................
Last Name:...............................................................................................................................................................
Email Address: .........................................................................................................................................................
Address:...................................................................................................................................................................
Phone: ......................................................... Mobile: ..............................................................................................
Date of birth: ............................................... Student ID number: ..........................................................................
Course of Study: .......................... ..............................................Year of Study: (e.g. 1st, 2nd) ................................
University of Canterbury Blues Awards 2013 – T: 03 364 3983 E: sara.luckman@ucsa.canterbury.ac.nz
Sports Record September 2012- September 2013
1) New Zealand Representative/National /Canterbury Coaching/Administrative Representative
2) Please describe the selection process for the position that you have listed above e.g. qualification time, selection
panel…
3) Year’s Best Performance and Times/Administrative/Coaching Achievements
University of Canterbury Blues Awards 2013 – T: 03 364 3983 E: sara.luckman@ucsa.canterbury.ac.nz
4) Current NZ/Canterbury Ranking (if appropriate)
5) University Club Membership and/or Coaching/Administrative Contribution
6) Are you a member of a university club?
If not please give reasons: (e.g. Not a club at UC or a no UC club playing at the required level)
Supporting Documentation
Please attach any materials verifying your involvement in an event or activity such as letters, references,
certificates, publicity material, prints of websites or other relevant documents in support of your application.
University of Canterbury Blues Awards 2013 – T: 03 364 3983 E: sara.luckman@ucsa.canterbury.ac.nz
The University of Canterbury Sportsperson of the Year
The most prestigious sports award presented is the Sportsperson of the Year. It is awarded to the student or
students who in the opinion of the panel have performed outstandingly at their sport during the year in
question.
The University of Canterbury Outstanding Contribution to University Sport
The Criteria will be based on:
1) Length of service to University/Tertiary sports development
2) Qualifications achieved on both Coaching and Administration
3) Personal and club achievements promoting club growth, club successes national and international
success
4) Other circumstances, such as personal contribution to student sport above and beyond duty
The award recipient need not be a student, but has contributed to student sport.
For individual sport criteria please see Blues Awards Criteria document.
2013 Presentation (Awards Ceremony)
The 2013 UC Blues Awards will be presented on Thursday 26th of September. You will be contacted in early
September with the results of your nomination. Should your application be successful you will be contacted via
email and will receive one free ticket upon received RSVP.
Please return this nomination form by 5pm on Friday 30th August 2013
Email sara.luckman@ucsa.canterbury.ac.nz
Hand deliver the form to the UCSA located on Level One, James Height Building. Reception is open Monday to Friday,
8.30am-4.30pm or
Post to University of Canterbury Students’ Association, PO Box 31-311, Ilam, Christchurch -Attention: Sara Luckman
If you have any further inquiries, please contact Sara on 364 3983 or by email sara.luckman@usca.canterbury.ac.nz
WAIVER
I authorize my name, voice or picture, and any other information given on this form to be used without payment in any
broadcast, telecast, advertising promotion or in any other way relating to this event. In addition, the UCSA has my
permission to have access to my academic results in the year of my application for the UC Blues Awards.
Name: ..................................................................... Signed: ..........................................................................................................
Address: .................................................................. Contact Phone Number: ...............................................................................
Nominated By: (if other than self) .......................... Position: ......................................................................................................
University of Canterbury Blues Awards 2013 – T: 03 364 3983 E: sara.luckman@ucsa.canterbury.ac.nz