Submission and materials deadline is Friday, May 3, 2019
Fill in the following information for the Applicant’s company. If the Applicant’s achievements are within a division or subsidiary, only use data for that specific business unit.
The Judges weight revenue and employment growth heavily in their evaluation. Profitability or other demonstration of value creation is also a key consideration. Please provide as much detail as possible.
EXTERNAL ADVISORS AND REFERENCES
Please list below the individuals who have assisted the Applicant in his or her entrepreneurial efforts, and who may serve as references.
Representatives of the NHTA EOY Committee may contact these advisors and references to verify information and gain a deeper insight into the Applicant.
To the best of my knowledge, the information provided herein is true and complete.
ALL FINANCIAL INFORMATION CONTAINED HEREIN SHALL REMAIN CONFIDENTIAL UNLESS I AGREE TO ITS RELEASE.
If I am selected for a NHTA Entrepreneur of the Year Award, I hereby authorize, in connection with the NHTA Entrepreneur of the Year Program and/or the NH Tech Alliance, the use of my name, my company’s name, non-financial information, likeness, photographs, video recordings, and audio recordings of me from whatever source. I agree that no compensation shall be due me or my company for such usage.
I understand that an interview will be conducted by a representative of the NHTA EOY Committee.
I also understand that if I am selected for the 2019 NHTA Entrepreneur of the Year Award, I will be required to attend the Awards Gala to receive my award. The event will be held on June 13.