Nomination Form | Australian BMX Hall Of Fame

1. Choose category for Induction

BMX Race

Rider (including Pioneers pre-1981)OfficialIndustry

BMX Freestyle

Rider (including Pioneers pre-1985)CultureIndustry

2. Nominee Information

Nominee's Name *

First Name

Last Name

Australian Citizen *

YESNO

Nominee's Phone Number

Area Code

Phone Number

Nominee's E-mail AddressNominee's Address

Street Address

Street Address Line 2

City

State

Postcode

Country

3. Your Information

Your Name *

First Name

Last Name

Your E-mail Address *Your Phone Number

Area Code

Phone Number

Your Address

Street Address

Street Address Line 2

City

State

Postcode

Country

4. Career Achievements

List as many achievements and career highlights as possible. Include State, National and International results, television appearances, BMX promotion and elevation of the sport in general, contributions to the sport, levels of Office obtained etc. Please provide dates/years where possible and provide as much detail as possible. Attach additional supporting documentation if required at the end of this form. *

4. Personal Attributes and Character

How has the Nominee used their success to impact the sport? *

5. Suspension or convictions

Has the Nominee been suspended due to serious breaches, brought the sport into disrepute or had any criminal convictions? If yes, provide details. *

If yes please provide details below.

Suspension details (if applicable)

6. Additional Supporting Documentation

Please attach any other supporting documentation here.

Please verify that you are human *I am human

Australian BMX Hall of Fame Inductee Nomination Form