IRELAND’S MOST POWERFUL WOMEN: TOP 25 AWARDS ENTREPRENEURS (For reference purposes only. All Nominations must be submitted online at https://top25.ie)
NOMINATOR INFORMATION Sal:
First Name:
Title:
Company/Organisation:
Street Address:
Town:
EIRcode (If applicable):
Country:
Telephone:
Email:
Executive Assistant Name:
Executive Assistant Email:
Last Name:
County / Postcode:
Executive Assistant Telephone:
How did you hear about the Top 25 Awards? Print Media
Broadcast Media
Colleague
WXN Partner
WXN Website
E-vite
Letter from WXN
Other:
NOMINEE INFORMATION Sal:
First Name:
Last Name:
First Name Phonetics:
Last Name Phonetics:
Title:
Company/Organisation:
Street Address:
Town:
EIRcode:
Country:
Telephone:
Email:
Date of Birth:
Executive Assistant Name:
Executive Assistant Email:
Executive Assistant Telephone:
County / Postcode:
Has the Nominee previously won the Award? Women who have won an Award twice are eligible for being inducted into the WXN Hall of Fame.
If yes, what year(s)? How many direct reports does the Nominee have? How many indirect reports does the Nominee have? To whom does the Nominee report? (Name, Title, Company)
Nominee’s Head Office Information Please fill in the following if Nominee’s head office information is different than above
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IRELAND’S MOST POWERFUL WOMEN: TOP 25 AWARDS ENTREPRENEURS (For reference purposes only. All Nominations must be submitted online at https://top25.ie) Company/Organisation: Street Address: Town: County / Postcode:
EIRcode (if applicable):
Country:
Please provide a brief overview of the Nominee’s organisation (Maximum 160 characters, approximately 25 words):
Industry Type (Please select all that apply): Aerospace and Defense
Airline
Automotive
Consumer Goods
Electronics and High Tech
Energy
Financial Services
Forest Products
Health Services
Human Services
Insurance
Life Sciences
Media and Entertainment
Metals and Mining
Non-Profit
Oil & Gas
Public Sector
Real Estate
Retail
Telecommunications
Travel
Utilities
Other:
ENTREPRENEURS CATEGORY QUESTIONS Each question must be answered in a maximum of 2500 characters (approximately 400 words). Business performance: The development and growth of the Nominee’s business will be considered, and where the company’s current turnover is below €3m, the company’s potential and future financial trajectory will also be considered.
Impact on Irish Thinking and Culture: How has the Nominee and her business had a measurable impact on Irish thinking and culture and where possible, demonstrate the originality of the business and how that has captured a niche or propelled business growth?
Vision and Leadership: How has the Nominee demonstrated vision and leadership within her current business and throughout her career?
Community Service: How does the Nominee demonstrate her commitment to the community?
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IRELAND’S MOST POWERFUL WOMEN: TOP 25 AWARDS ENTREPRENEURS (For reference purposes only. All Nominations must be submitted online at https://top25.ie)
FINANCIAL DATA Organisation Name: 2014 Annual Sales Income After Taxes EBITDA** Total Assets Total Equity **Earnings before interest, taxes, depreciation and amortization
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2015
2016
IRELAND’S MOST POWERFUL WOMEN: TOP 25 AWARDS ENTREPRENEURS (For reference purposes only. All Nominations must be submitted online at https://top25.ie)
CONFIRMATION OF TRUTH OF INFORMATION AND RELEASE I understand that the detailed financial information is shared only with the 2-3 judges in the category, the Advisory Board Chair and a two-person secretariat. I understand that each of these individuals has signed a confidentiality agreement in accordance with the Nomination process. If my Nominee is selected as a Top 25 Award Winner, I hereby authorize the release and use, in connection with the Ireland’s Most Powerful Women: Top 25 of their name, company’s (or organisation’s) name, non-financial information, photographs, video or audio recordings in any form of media, from whatever source. I agree that no compensation shall be due me or my company for such usage.
ADDITIONAL DOCUMENTS (to be uploaded) 1. Internal Letter of Reference (one page maximum) May be provided by anyone within the organisation of the Nominee, including a member of the organisation’s board of directors. 2. Senior Leadership Organisational Chart 3. Nominee’s Digital Headshot (High-resolution, colour image) Minimum 500kb – Maximum 2mb 4. Nominee’s Biography (one page maximum)
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