2013Creative Young Entreprenuer AwardsNOMINATION FORM

Section1: Nominee Information

Nominee's first/given name:
Nominee's second/family name(s):
Title: (Dr., PH.D, etc.)
Name to appear in JCI Publications:
Citizenship:
Mobile telephone No.:
(Along with Country Code)
E-mail:
Date of birth:

Section2: Company Information

Name of Company:
Full international mailing address:
Country:
Business Phone Number: (Along with Country Code)
Website:
Brief description of the business: (Additional information can be attached on a separate sheet)
What year was the business founded?:
What percentage of the company does the nominee currently own?
Is the nominee actively involved in top management?
What year did the nominee assume responsibility?
Please provide a brief description of the nominee's management responsibilities
Describe the company's target market:
Explain how the company complies with UN Global Compact's ten principles, regarding to Corporate Social Responsibility, during daily activities

Section 3: The Creative Entrepreneur

Describe the company - its current stage of development, its core activities, size, market strategy, position in the market, and what sets it apart from its competitors.
Describe the nominee's entrepreneurial achievement for which you are nominating them for the Creative Young Entrepreneur Award. Please give details about the use of creativity, ingenuity and innovation in management approach, market strategy, customer service, use of technology, or any other aspect of the company.
Describe the degree of difficulty in launching and building the company, or in implementing the changes of the established company - the risks involved, obstacles to overcome, and how they were overcome, how it was financed, staffed, and operated, etc.
Describe the success of the company with specific attention to indicators of success such as financial growth, market size, growth of company, job creation, positive impact on the market, reduced costs, etc.
Please outline the plans and prospects of the nominee for the company's future and how they demonstrate creative planning skills.

Section 4: The Guiding Principles

Describe the leadership qualities of the nominee in the following specific areas:
• As a Manager
• As a Visionary
• As a Coach
• As a Educator
• As a Ambassador
• As a Learner
Describe how the work environment and culture established by the nominee respects, recognizes and rewards employees. Include a description of the overall structure.
List business, charitable and community organizations to which the nominee belongs to and the extent of their involvement. Include specific examples of how the nominee demonstrates vision and creativity in a socially beneficial way.

Section 5: Related Documents

Copy of ID/Birth Certificate:
A certified copy of the ID/Birth Certificate should be attached along with the nomination form to prove the age of the nominee.
We accept any official document indicating the birth date of the nominee.
JCI requests this document to check that the nominee is in JCI age.
Attach photograph:

Section 6: Nominator Information

The nominator and the nominee are the same person
Answer these questions only if you are nominating someone other than yourself
Name of Nominator:
Name of Company/Organization:
Title:
E-mail:
Telephone No.: