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Nomination Form

Please contact us if you have additional questions or need assistance in completing this nomination form. After you complete the online nomination, you will be sent a email confirming your Australian Bicycling Achievement Awards nomination has been received.

Contact us if you do not receive a email confirmation within 1-2 working days, or, if upon submitting the form you are not directed to the thank you page.

  • Email: office@cyclingpromotion.com.au
  • Phone: (03) 9533 3170 | Fax: (03) 9533 3149
  • Ground Floor, Suite 2 | 616 St. Kilda Road, Melbourne | Victoria 3004

 

Your details
Nominee's Details (i.e.: details of individual/s, group and/or activity)
Category Entered
About the Nominee
Please provide a short summary of the nominee’s contribution to cycling, or outline of the activity to support the nomination (up to 100 words) This will be used in the 2010 Australian Bicycling Achievement Award booklet.
Please provide a more detailed outline of the contribution made by the person/organisation/school/business. Consider the eligibility criteria for the award you are nominating - it provides some tips on what to consider when making a nomination.
5 MB maximum file size. This includes supporting evidence for your nomination. such as photos & documents. If you have difficultly using this file upload function or have larger files than 5MB, please email us directly: office@cyclingpromotion.com.au and include the name of your nomination and contact details.