This form must be completed, signed and returned to Ernst & Young Solutions LLP at the address stated behind.
To be eligible for the award, the nominee must fulfill either one of the following:
► An owner-manager primarily responsible for the recent performance of a privately held Singapore-based company that is at least
two years old.
► A founder of a listed Singapore-based company who is still active in senior management.
The information provided in this participation form will be strictly confidential and will be used only by Ernst & Young, the major sponsor(s) and the
independent panel of judges during the selection process.
Nominee
Name(s)*:
Salutation:
Dr/Mr/Mr/Mdm/Ms
Company:
Designation:
NRIC/Passport number:
Date of birth:
Email:
Tel/Fax:
Company address:
Company website:
*Please attach business card(s) ** For joint nominations, please provide information of all joint nominees.
Description of business
Provide a brief description of the business (e.g., products/services). Include the most recent Accounting and Corporate Regulatory Authority
(ACRA) business profile and any marketing collateral relating to the business.
In which year was the company founded?
In which year did the nominee assume leadership?
What percentage of the company does the nominee presently own?
What is the legal structure of the nominee’s business?
Sole proprietorship
Partnership
Private limited company
Public listed company
If listed, in which year did the company obtain its listing?
Has the nominee or the nominee’s company been subjected to any litigation or conviction in a court of law, or
investigation by a government or regulatory body in the last five years?
Yes
No
If yes, please provide brief description:
Financial information
Financial information is an important quantifiable indicator of success to the independent panel of judges. It is