GOLD COAST SPORT TECHNOLOGY OR INNOVATION AWARD NOMINATION FORM First Name *Last Name *Email Address *Mobile Phone No. *Is the business you are nominating your business? *Please select an optionYesNoPlease provide the names and contact details of three refereees who can substantiate your business or progamReferee # 1First Name *Last Name *Email Address *Mobile No. *Referee # 2First Name *Last Name *Email Address *Mobile No. *Referee # 3First Name *Last Name *Email Address *Mobile No. *What is the name of the person, product or business you are nominating *Please provide the business owner's contact details.First Name *Last Name *Email Address *Mobile No. *Website URLWhat is the product/program/technology’s primary function (EG, fan engagement, skill development, etc) *How does the product specifically benefit the user? *0 / 500Is the product or program currently in use? *Please select an optionYesNoIf so, please give detailsIs the business on the Gold Coast? *Please select an optionYesNoIf no, is the business in operation on the Gold Coast?YesNoPlease provide further information such as case studies, user testimonials, proof of concept, client reviews, product images, etc,Upload supporting documents (Max 20MB)Choose FileNo file chosenDelete uploaded fileSupported Formats: PDF, JPG, DOCX, XLXSSUBMIT
