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ST.
JOHN’S PARK PANTHERS
SLOVENIAN AWARDS APPLICATION FORM
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Closing
date 31st May 2003
A separate Application Form & Submission is required for
each Award Category you enter.
1. AWARD CATEGORIES: (Please tick to indicate the Award Category
you are entering)
NSW – SlovenianApprentice of the Year
NSW – Slovenian Primary student of the Year
NSW – Slovenian Secondary student of the Year
NSW – Slovenian Tertiary student of the Year
NSW – Slovenian Outstanding Senior Citizen of the Year
NSW – Slovenian Entrepreneur of the Year
NSW – Slovenian Outstanding Volunteer of the Year
A Winner and Highly Commended entrant will be chosen for each category.
Please specify the Category you are entering.
2. ENTRANT DETAILS (please fill in as required)
Business/Organisation/Individual:_________________________________________________
Address:______________________________________________________________________
Mobile No:_______________________________________
Tel:____________________________________________
Fax:____________________________________________
Email:__________________________________________
Contact Name: __________________________________
Position:________________________________________
Type of Business:_________________________________
Date business Commenced:________________________
Name of person nominating:_____________________________________________________
DECLARATION
I certify that the information submitted is true.
Signature……………………………………….
Date…………………………
Name (printed)………………………………….
Position……………………….
Send
completed applications to: Panthers St John’s Park Community
Club
PO Box 63 Canley Heights NSW 2166
Or fax to: (02) 9823 2522 email
to: Lesley.blefari@panthers.com.au
