Stelios Award for Disabled Entrepreneurs in the UK 2013
Application Form - Nomination
Eligibility criteria for the nominee
- Has a recognised disability or long term health condition
- Has at least 25% management stake in the company
- Business has a turnover in excess of £10,000
- UK registered business
- Trading for between 1 and 5 years
* Mandatory fields
Please complete form electronically
To nominate someone for the Award, please answer the following questions before asking the nominee to complete the form and submit before the deadline.
* Your Name * Nominee’s Name
* Your Relationship to Nominee * Nominee’s Company Name
* Your Phone Number * Your Email Address
* Why are you nominating this entrepreneur for the Award?
* As a disabled entrepreneur, what are some of the challenges that the nominee has faced and how have they overcome them? (200 words allowed)
* Please tell us how you found out about this year's Award
Word of Mouth
Leaflet ______
Search Engine ______
Website ______
Article ______
Other ______
Contact Details
* First Name * Last Name
* Date of Birth
/ /
* Company Name
* Company Address
Address line 2
* City* Postcode
* Country
* Email Address Website Address
* Telephone Number Mobile Number
Company Details
* Business Sector
* Nature of Business
* Main Product/Service
* Number of Employees
* Legal Status of Company
* Date Business Registered* Date Trading Began
(No earlier than Apr 08, no later than Oct 12)
/ / / /
* What percentage management stake do you have in the business?
Figures
Year 2011/2012 / Year 2012/2013 / Projection 2013/2014* Turnover (£)
* Net Profit (£)
Please attach audited accounts for 2012/13 with your application
* Please describe your disability
* As a disabled entrepreneur, what are some of the challenges you have faced and how have you overcome them? (200 words allowed)
* Please provide a brief description of your business, the products or services it supplies, its customers and the markets in which you operate, and how you run the business (200 words allowed)
* Please outline the overall trend in your sales turnover and profit development, together with a brief description of key strategies that have led to these changes
Consider the following: marketing, workforce development, customer recruitment and retention, environmental impact, financial planning and control, supplier relationships and management, operations, IT, and innovations (500 words allowed)
* What are your objectives for the business over the next 3 years and how would winning £50k help you achieve them? (200 words allowed)
* Is your business currently involved in any court cases?
Yes No
* Please confirm that all of the information in this application form is true and accurate
Yes No
* Please confirm that you have attached your audited accounts for 2012/13
Yes No
If you have any other attachments to support your application, please include them
(max. 2 MB)
Thank you for completing the application form.
Please email it, along with a copy of your audited accounts, to or send it in the post before the deadline of 5pm on 25th October 2013 to:
Strategic Partnerships & Innovative Services
Leonard Cheshire Disability
66 South Lambeth Road
London SW8 1RL
We will contact you in November to let you know if your application is successful.
Good luck!