Nomination Form

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Kids On The Border Sponsorship Nomination

: ****Please note we have 2 submission / intake months throughout the year. January & July. If you are submitting outside of these months please come back within those two months.
Name of Child:: First Name:
Last Name:
Age:: 5-10yrs11-15yrs16-18yrs
Gender:
Post Code:
Chosen Activity:: SportMusicArtAcademicOther
Other Option
Achievements in chosen activity:
What can Kids On The Border do to help to get them to the next level:: Include dates of events you may need funding assistance and value.
School:
Club:: Sporting Club, Music group etc
Any further information you'd like to share:
Nominee Details
Name:: First Name:
Last Name:
Relationship with nominated child:: Parent, Coach, Relative, Teacher
Email:
Phone:

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