Title
MCNA Long Service Award 2020
For volunteer service to Netball within the Area of Jurisdiction of Middlesex County Netball Association
Award Criteria
• Volunteer must be affiliated to England Netball and Middlesex County Netball Association.
• Volunteering must be for a minimum of 10 years of service excluding playing history.
• Volunteering can be split to achieve a minimum of 10 years of service through Club, League and/or Middlesex County Netball Association.
• Self-nomination is permitted.
• All nominations must be endorsed by an Officer of the relevant organisation/s to which service has been given.
Deadline for entries is midnight on 31st May 2020.
Winners will be announced at the AGM on 25th June 2020
NOMINEE INFORMATION - Name
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First
Last
Address (including postcode)
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Nominee Email
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Phone Number
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England Netball Affiliation Number
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Years of Service
*
NOMINATOR INFORMATION - Name
*
First
Last
Address (including postcode)
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Nominator Email
*
Phone Number
England Netball Affiliation Number
Organisation
*
Position of Nominator
*
ENSORSER INFORMATION - Name
*
First
Last
Address (including postcode)
*
Endorser Email
*
Phone Number
England Netball Affiliation Number
Organisation
*
Position of Endorser
*
NETBALL ROLES
Please ensure these roles are at Club, School, League and/or County Level and DO NOT include playing history. Ensure that the time span covers a period of at least 10 Years. All roles/periods of volunteering will be verified with the relevant parties and any discrepancies in the information provided will be taken into account.
Role:
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Organisation
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Period From
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DD
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MM
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YYYY
Period To
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DD
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MM
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YYYY
Voluntary (YES/NO)
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Yes
No
Role 2
Organisation
Period From
DD
/
MM
/
YYYY
Period To
DD
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MM
/
YYYY
Voluntary (YES/NO)
Yes
No
Role 3
Organisation
Period From
DD
/
MM
/
YYYY
Period To
DD
/
MM
/
YYYY
Voluntary (YES/NO)
Yes
No
Role 4
Organisation
Period From
DD
/
MM
/
YYYY
Period To
DD
/
MM
/
YYYY
Voluntary (YES/NO)
Yes
No
Role 5
Organisation
Period From
DD
/
MM
/
YYYY
Period To
DD
/
MM
/
YYYY
Voluntary (YES/NO)
Yes
No
PRIVACY STATEMENT
The personal information provided on this nomination form will be processed by Middlesex County Netball Association for the legitimate purpose of administering the nomination for the Long Service Award.
Limited personal information related to Nominees and Award winners provided on this form will be retained indefinitely for historical and reporting purposes. For further information about what data we collect, why it is collected, what we do with it etc. please see our full privacy policy at:
www.middlesexnetball.co.uk/mcna/index.cfm/aboutus/data-protection-privacy-notice/
By submitting this form online I confirm I have read the Privacy Statement on the website.
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