AWARDS FORM SUBMISSION

Name

Email Address

Company Name

Phone

Mailing Address

City, State, Zip

Website

Year Established

Number of Employees

Annual Revenue

Award Category Award CategorySelect an Award CategoryEmerging Business of the YearMicro-Business of the YearSmall Business of the YearMedium/Large Business of the YearEmployer of the YearEntrepreneur of the YearNon-Profit of the YearMinority-Owned Business of the YearFemale-Owned Business of the YearVeteran-Owned Business of the YearYoung Entrepreneur of the YearFastest Growing Business of the YearExcellence in Mentorship AwardThe John Myslak Award for Servant LeadershipCommunity Vibrancy Award

What is your company’s mission statement?

Do you participate in Studer Community Institute’s training opportunities? Do you participate in Studer Community Institute’s training opportunities? Yes No

• If yes, select the programs you participate in: • If yes, select the programs you participate in: Live Training EntreCon® Accelerate Roundtable On-Demand Training Custom Training Leader Certification

• If no, what training opportunities do you participate in or offer your employees?

In the space below, please tell us your story and why you should be considered for an EntreCon® Award. Refer to the category description on the EntreCon® website and align your response with the requirements: