Who would you like to nominate for assistance? Which event would they like to participate in?*Mt MaunganuiRotoruaSouth AucklandCentral West AucklandCentral East AucklandHastingsHamiltonGisborneChristchurch AMChristchurch PMDunedinNelsonHutt CityWellingtonPalmerston NorthHibiscus CoastNew PlymouthBay of IslandsNominated Group Type:*Church groupGirl GuidesSchool groupScoutsSports clubOtherSchool decile:12345678910OtherSchool role:Nominated Group Name:*Nominee Email Address:*This will be used to contact your nominee if your application is successful. Nominee Contact Phone Number:*This will be used to contact your nominee if your application is successful.Your detailsYour Name:*Your relationship to the nominee:*Community Group LeaderFriendGroup AdministratorTeacherOtherOtherYour Email Address:*This will be used to contact you if your application is successful. Your Contact Phone Number:*This will be used to contact you if your application is successful.Group Nomination DetailsI would like my nominated group to receive:*Assistance with the cost of participant registration fees.Assistance with obtaining the equipment necessary to participate.How many subsidised entries does your nominated group require?*What equipment does your nominated group need assistance with obtaining?* Bicycles Helmets Running shoes Other OtherHow many participants does your nominated group require this equipment for?*If this equipment cannot be purchased on behalf of the nominee, would having this equipment hired for use on the event day still be useful?*YesNoWhy do you believe your nominated group deserves to receive assistance?*Why would the group you are nominating not otherwise be able to enter the event?*What other activities is your nominated group undertaking to assist with entry into the event?*Individual Nomination DetailsI would like my nominee to receive:*Assistance with the cost of participant registration fees.Assistance with obtaining the equipment necessary to participate.What equipment does your nominee need assistance with obtaining?* Bicycle Helmet Running shoes Other OtherIf this equipment cannot be purchased on behalf of the nominee, would having this equipment hired for use on the event day still be useful?*YesNoWhy do you believe your nominee deserves to receive assistance?*Why would the candidate you are nominating not otherwise be able to enter the event?*What other activities is your candidate undertaking to assist with entry into the event?*Have you submitted a nomination to the Weet-Bix TRYathlon Foundation before?*YesNoDisclaimers* I have obtained the consent of the nominee's parents or legal guardian(s) to make this nomination. * * I understand in submitting this application that an application does not constitute an obligation on behalf of the Weet-Bix Kids TRYathlon Foundation. * * I understand that by making a submission for assistance, to the Weet-Bix Kids TRYathlon Foundation on behalf of the Nominee(s) above, I consent to being contacted (electronically or otherwise) with regards to this application. I also consent to my nomination, name and image being used for publicity purposes relating to the work of the Foundation, subject to the consent of the nominee's parent or guardian. * PhoneThis field is for validation purposes and should be left unchanged.
