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  • DSR Awards 2016 Nomination Form – Inclusive Infrastructure

    Nominee Details

    First Name * :

    Last Name * :

    Address * :

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    State * :

    Postcode * :

    Mobile * :

    Email * :

    Organisation (where applicable) :

    Is the nominee aware of this nomination? *:

    Nominated by

    I am self nominating.

    First Name * :

    Last Name * :

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    Email * :

    Relationship to nominee (ie. Family member, colleague, coach, organisation) * :

    How did you find out about the awards?

    Please specify the other


    Questions - Inclusive Inclusive Sport, Recreation or Open Space Infrastructure


    Two awards will be presented for the Inclusive Inclusive Sport, Recreation or Open Space Infrastructure Award, one for a development under $500,000 (minor) and one for over $500,000 (major).

    1. Were any individuals with disability or disability groups consulted regarding the sport, recreation or open space infrastructure build/retrofit?

    Please list the groups involved and provide further explanation (maximum 100 words)

    2. What was the budget for the infrastructure development?

    3. The following statements refer to the design of the facility. Please select all that are applicable.

    4. Please provide an explanation as to why the sport, recreation or open space infrastructure should be recognised as most outstanding. Please include a summary of the facility design, including how it addresses Universal Design principles, as well as demonstrating its welcoming and inclusive culture.
    Minimum 300 words, maximum 600 words.

    Extra Information

    You may attach supporting evidence (no more than three A4 pages)(Allowed file types:gif|png|jpg|jpeg|pdf & file size max 2mb)

     

    Please upload one – two photos of the nominee.(Allowed file types:gif|png|jpg|jpeg & file size max 2mb)

    Photo 1:

    Photo 2:


    Who can we contact in support of this nomination?
    Please provide at least one reference.

    Referee details


    Referee One

    First Name * :

    Last Name * :

    Email * :

    Mobile * :

    Relationship to nominee (ie. Family member, colleague, coach, organisation) * :

    Referee Two

    First Name :

    Last Name :

    Email :

    Mobile :

    Relationship to nominee (ie. Family member, colleague, coach, organisation) :

    Before you submit your nomination, please print a copy for your records