Nomination Form

We will send you an email confirming that we have received your nomination. If you do not receive email confirmation or if upon submitting the form you are not directed to the thankyou page, please contact us directly.

Feel free to contact us if you have any questions or need assistance in completing the nomination form.
Email: office@cyclingpromotion.com.au Phone: 03 9818 5400 Fax: 03 9818 4535

You can also download an electronic copy of the nomination form here (PDF, 52kb)

Your Details

First Name:

Last Name:

Organisation/School/Business/Government Department:

Position:

Postal Address:

Town / City:

State:

Postcode:

Phone number:

Email: *

Website:

Nominee's Details

First Name:

Last Name:

Organisation/School/Business/Government Department:

Position:

Postal Address:

Town / City:

State:

Postcode:

Phone Number:

Email:

Website:

Category Entered

Choose a Category: *

Cycling Promotion Award of the Year Professional category

Cycling Promotion Award of the Year Honorary category

Special Achievement Award by a Bicycle Organisation

Local Government Award for Initiative to Encourage and Promote Cycling

Award for Educational Institution for Innovation in Encouraging Cycling to School

Award for Bicycle Friendly Business

Award for Contribution towards Cycling by a Politician

Award for Contribution towards Cycling by a Bicycle Retailer

About the Nominee

Summary of Nomination (100 words maximum):

Please provide a short summary of the nominee’s contribution to cycling, or outline of the program/initiative to support the nomination (up to 100 words) This will be used in the Bicycling Achievement Award booklet

Detailed Outline of the Nomination (800 words maximum):

Please provide a more detailed outline of the significant contribution made by the person/organisation/school/business to advance, encourage and improve cycling. Please consider the eligibility criteria for the award you are nominating - it provides some tips on what to consider when making a nomination.

Accompanying Photo / Document (Optional):

5 MB maximum file size. This may include short resume or a product photo.

Nomination Form

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2007 Awards Booklet

Award Categories