2017 PRIDE IN SPORT LGBTI INCLUSION INITIATIVE AWARD

This submission recognises innovative products, services or initiatives that promote the inclusion of LGBTI people within NSO’s, SSO’s, Clubs or the sport more generally.

SUBMISSIONS MUST BE RECEIVED BY PRIDE IN SPORT NO LATER THAN 5PM AEST 24TH MARCH, 2017

Please send to:

or Pride in Sport, 1st Floor, 414 Elizabeth Street, Surry Hills NSW 2010

or Pride in Sport, PO Box 350, Darlinghurst NSW 1300

INITIATIVE DETAILS

Name of Initiative / Please enter name as you would like it to appear on certificates or any awards if applicable
Club/SSO/NSO/Group responsible for the initiative: / Please enter name as you would like it to appear on certificates or any awards if applicable
Was the initiative primarily targeting a regional / rural area? / Yes / No
Which group was the initiative targeting (delete any statements not applicable): / Youth Sport
Amateur Sport
Professional Sport

NOMINATION CONTACT DETAILS:

Contact Person for nomination:
/ Name:
Postal address:
Phone number:
Email:

DISCLOSURE

Please verify that the information contained within this submission is accurate understanding that errors in the submission could result in the withdrawal of any awards. / Yes / No
Name of Person verifying accuracy:

PLEASE READ THROUGH ALL THE NOMINATION QUESTIONS before entering any information to ensure that you place your nomination data within the right sections.


Q1 INITIATIVE NOMINATED

(a) / Please describe in more details the initiative that you are nominating for this award.
(b) / Please provide a little history as to how this initiative came about or why it was implemented?

Q2 CONTRIBUTION OF INNOVATION: Please identify all the ways in which this initiative has or will contribute to LGBTI inclusion? Please add a new row for each unique area of contribution.

/ ‘X’ in first column for each row that applies / Evidence required / Evidence provided
Please indicate filename if your evidence has been included as a file. /
(a) / Areas of contribution to LGBTI inclusion in sport / Evidence provided? Yes / No / Provide evidence here. If your evidence has been attached as a separate file, please indicate that here and provide the name of the file.

Q3 IMPACT MEASURES: Please identify any results that you have been able to quantify as a direct result of this innovation in terms of increasing LGBTI inclusivity or awareness within your sport or beyond. Please add a new row for each unique response as required.

/ ‘X’ in first column for each row that applies / Evidence required / Evidence provided
Please indicate filename if your evidence has been included as a file. Filename must include the Question number and row reference letter ie. XYZ Company – Q1 – Row A. /
(a) / Quantifiable results / Evidence provided? Yes / No / Provide evidence here. If your evidence has been attached as a separate file, please indicate that here and provide the name of the file.


Q4 REACH: Please identify the reach of this initiative. Please add a new row for each unique response as required.

/ ‘X’ in first column for each row that applies / Evidence required / Evidence provided
Please indicate filename if your evidence has been included as a file. Filename must include the Question number and row reference letter ie. XYZ Company – Q1 – Row A. /
(a) / Reach: Who does this impact? Spectators, Players, Parents? Please identify the reach of your initiative. / Identification of reach and where possible, evidence. / Provide evidence here. If your evidence has been attached as a separate file, please indicate that here and provide the name of the file.

Q5 RECOGNITION: Please identify any internal or external awards/recognition for this innovation. Please add a new row for each unique response as required.

/ ‘X’ in first column for each row that applies / Evidence required / Evidence provided
Please indicate filename if your evidence has been included as a file. Filename must include the Question number and row reference letter ie. XYZ Company – Q1 – Row A. /
(a) / Internal or external recognition received for this initiative. / Please identify if the recognition is:
(a)  Internal
(b)  External
(c)  State
(d)  National
(e)  Global / Provide evidence here. If your evidence has been attached as a separate file, please indicate that here and provide the name of the file.

Q6 KEY REASONS FOR NOMINATION

/ ‘X’ in first column for each row that applies /
(a) / In one short paragraph, please articulate the most significant reason for why this work should be given this award.


Q6 REFERENCES SUPPORTING NOMINATION

Please provide as many of the following references as you can in support of your nomination.

/ ‘X’ in first column for each row that applies /
(a) / Please provide a Senior letter of endorsement from within your sport for this initiatives and its current or potential impact.
(b) / Please provide endorsements from one or more people who will benefit from the initiative (or have benefitted from it already).
(c) / Please provide one or more external endorsements of the initiative (if applicable).
2017 PRIDE IN SPORT INCLUSION INITIATIVE AWARD Page | 3