Wufoo

SA Great Regional Awards Online Nomination Form

PLEASE COMPLETE ALL SECTIONS BELOW ACCURATELY. ALL NOMINATIONS MUST BE RECEIVED BY SA GREAT NO LATER THAN FRIDAY 11th JULY 2008 at 5pm. Please see the ELEGIBILITY & CRITERIA section of this website for conditions of entry.

* Mandatory Fields
Nominee Details:

(eg: yourself, an individual, business, organisation, event or project)
I nominate: *
Postal Address
Suburb
State
Post code
Phone
Email
Region: *
Adelaide Hills Barossa & Light Eyre Peninsula Fleurieu Peninsula/Kangaroo Island Flinders/Outback Limestone Coast Mid North/Yorke Peninsula/ Southern Flinders Riverland/Murraylands

# The nominees in the tourism category will be contacted by Adelaide Hills Tourism
Nomination Category *
ETSA Utilities ARTS AWARD Westpac COMMUNITY GROUP AWARD Westpac COMMUNITY INDIVIDUAL AWARD Australia Post SMALL BUSINESS AWARD Australia Post LARGE BUSINESS AWARD Department for Trade and Economic Development INNOVATION AWARD SA Water SUSTAINABILITY AWARD Nippy’s SPORTS AWARD South Australian Tourism Commission TOURISM AWARD Adelaide Showground YOUTH AWARD

(Please tick box – maximum two categories per nominee)
Why are you nominating this nominee for an SA Great Regional Award?

(Please Note: Nominees activities/achievements must have occurred between July 2007 and June 2008)
Maximum 50 words
Nominator (your details)
Your Name
Postal Address
Suburb
State
Post code
Phone
Your Email
YES I am happy if SA Great advises the nominee that I have made the nomination I declare that all of the information submitted is true and correct. The nominee will be contacted and sent an entry form to be eligible for the award
Market Research

How did you find out about the Regional Awards Program? (please tick more than one if applicable)
Nominated in previous years Word of mouth family and friends Nominated by someone Nomination form in the post (addressed) Letterbox (not addressed) Newspaper Website Regional Development Board Post Office Radio Television Poster Other

(please tick more than one if applicable)
If other please specify
Do Not Fill This Out

Wufoo

SA Great Regional Awards Online Nomination Form

* Mandatory Fields

Nominee Details:

Nominator (your details)

Market Research