Number
of candidates :
Please choose number of candidates before proceeding. |
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List out partners |
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Contact Information |
Name of the company:
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| E-Mail Address:
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| Address:
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| Postal Code:
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| Telephone
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| Work
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| Residence
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| Fax
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| Nominated by (if other than the entrepreneur):
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| Telephone:
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| Information
Concerning Your Company
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| 1. Your company has been in operation since: (month / year)
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| 2. Include a copy of your business plan and marketing plan with the answers
to the following questions; If not available, please answer the following
questions:
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(Business plan and marketing plan)
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(PDF, HTM, HTML, RTF ,DOC)
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| I) Description of the company and the nature of its operation
(products/services).
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You have
1000 characters left.
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| II) Description of the target market and of your major competitors.
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You have
1000 characters left.
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| III) List your short, medium and long term goals.
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You have
1000 characters left.
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| IV) Why did you start your business?
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You have
1000 characters left.
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| V) At the beginning, how was your company financed and how is your company's
growth being financed?
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You have
1000 characters left.
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| VI) Please include a copy of your financial statements including a balance
sheet and a profit and loss statement for at least the past two years.
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3. Does the company contribute to an increase in the wealth of the region
either through export, import replacement, subcontracting, or other activities
such as tourism?
(Please supply as much information as possible.)
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You have
1000 characters left.
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| 4. Does your company have a human resources development plan?
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(If so, please supply a copy of that plan)
(PDF, HTM, HTML, RTF ,DOC)
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(If not, please supply information as to what type and what frequency of
training is offered to your employees.)
You have
1000 characters left.
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| 5. Indicate number of employees including part-time, permanent and seasonal
jobs in 2010 and 2011.
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You have
1000 characters left.
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(If you answered yes to one of those questions, please provide a brief
description)
You have
1000 characters left.
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7. Is the candidate involved actively in his or her community's
development?
(Please describe in detail)
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You have
1000 characters left.
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8. Was the candidate recognized by his peers for any recent special
achievements?
(Please describe in detail)
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You have
1000 characters left.
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| 9. Please feel free to add any other pertinent information which has not
been asked in this questionnaire, or describe any challenges which the
candidate had to face. |
You have
1000 characters left.
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| 10. How did you hear about the Young Entrepreneur Award 2011? |
You have
1000 characters left.
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| The
Company's References
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| A) BUSINESS REFERENCES |
| Name of your financial institution: |
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| Name of your account officer: |
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| Telephone:
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| Fax:
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B) OTHER REFERENCES
(such as your accountant, supplier or a major customer who is familiar
with your business) |
| Name: |
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| Occupation: |
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| Telephone: |
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| Fax:
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| Please note: To be eligible, companies must have been in
operation in the Chaleur region for at least two years. The Selection Committee
reserves the right to ask additional information from finalists. |
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ATTESTATION
I attest that all information contained in this document is exact and
complete. I authorize the Community Business Development Corporation as well as
the Selection Committee to make any verification it deems necessary with my
financial institution or my accountant.
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| I understand and agree that any false information contained in this document or
any of its attachments will automatically cancel my nomination.
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