Nomination for Lacrosse Certificate of Merit Award - Free Download
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Updated March 2015
Unit 115/396 Scarborough Beach Road, West Point Centre, Osborne Park WA 6017
Postal Address PO Box 1633, Osborne Park WA 6916
Telephone 08 9444 0008
Email firstname.lastname@example.org Website www.lacrossewa.com.au
NOMINATION FOR CERTIFICATE OF MERIT AWARD LWA15
1. Nominations must be lodged with Lacrosse WA before 30 June for consideration that same year.
2. Nominations must be in writing, signed by the Nominator and signed by a Seconder. In the first instance the
nomination may be e-mailed followed by post if required.
3. As the amount of detail provided to support the nomination may vary in each case, minimum space has been
4. This header sheet must also be lodged.
Full Name of Nominee
Date of Nomination
Please provide a currant Email address
Name of Nominator & Email Contact Address
Name of Seconder
Signature of Nominator
Signature of Seconder
Set out below the reason(s) why the Nominator & Seconder believe the Nominee should be awarded an
Association Certificate of Merit (use additional pages as required).
Please forward to email@example.com