Nominate Form

Company

This field is for validation purposes and should be left unchanged.

Who would you like to nominate for assistance?*

An individual

A group

Which event location would they like to participate in?*

Nominated Group Type:

School Group

Church Group

Sports Club

Other

Nominee Contact Phone Number*

This will be used to contact your nominee if your application is successful.

Nominee Email Address*

This will be used to contact your nominee if your application is successful.

I would like the nominees to receive:*

Assistance with the cost of participant registration fees

Assistance with obtaining the equipment necessary to participate

How many subsidised entries does your nominated group require?*

What equipment does your nominated group need assistance with obtaining?*

Bikes

Helmets

Running shoes

How many participants does your nominated group require this equipment for?*

Why do you believe your nominated group deserves to receive assistance?*

What other activities is your nominated group undertaking to assist with entry into the event?*

Have you submitted a nomination to the Weet-Bix TRYathlon Foundation before?*

Yes

Disclaimers*

I have obtained the consent of the nominee's parents or legal guardian(s) to make this nomination.

I understand in submitting this application that an application does not constitute an obligation on behalf of the Weet-Bix Kids TRYathlon Foundation.

I understand that by making a submission for assistance, to the Weet-Bix Kids TRYathlon Foundation on behalf of the Nominee(s) above, I consent to being contacted (electronically or otherwise) with regards to this application. I also consent to my nomination, name and image being used for publicity purposes relating to the work of the Foundation, subject to the consent of the nominee's parent or guardian.

I need help!

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