Suite 46, 239 Magill Road, Maylands, SA, 5069, AustraliaWebsite: www.tabletennis.org.au

Email: ceo@tabletennis.org.auABN 49 147 023 069

TTA HALL OF FAME NOMINATION FORMPlease submit this form, together with any supporting documentation, to Scott Houston, TTA CEO at ceo@tabletennis.org.au.

Please ensure you have read and understood the TTA Hall of Fame Regulations prior to submitting a nomination.

NOMINATOR DETAILSNominator Name Nominator PhoneNominator Email

NOMINEE DETAILSNominee NameNominee PhoneNominee EmailState/TerritoryTTA Hall of Fame Nomination Category(highlight as appropriate)

Athlete (Open)Athlete (Para)Athlete (Veterans)Coach Referee UmpireAdministratorLegend of the TTA Hall of Fame

NOMINEE INFORMATIONPlease provide specific and exhaustive information to demonstrate the Nominee’s ability to meet the Objective Criteria for Induction for the relevant category, as set out in clauses 5.5.1 (a) – (d) of the TTA Hall of Fame Regulations.For cases where the Nominee does not meet the Objective Criteria for Induction (as specified above), please provide specific and exhaustive information to demonstrate the Nominee’s ability to meet the Subjective Criteria for Induction for the relevant category, as set out in clause 5.6.1 to 5.6.3 of the TTA Hall of Fame Regulations.Please provide any other information (if applicable) to support the nomination.

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