"Up-and-Coming Entrepreneur"- Nomination Form

Companies must be located as a primary place of business in Georgia, Florida, South Carolina or North Carolina. All companies and products are eligible for consideration based on their business accomplishments made during calendar 2012. Companies may be nominated for multiple award categories, and companies may win multiple awards. There are no fees to nominate companies for consideration. TiE Membership/Sponsorship is not a criterion for selection.

Candidates for the Up-and-Coming Entrepreneur award must meet the following specific criteria:
- Age is not a criteria.
- Demonstrated progress in entrepreneurship in 2012.

- The deadline for all nominations is April 10, 2013
- Attendance at the conference is encouraged. The awards portion of the TiECON Southeast 2013 Conference will be held from 4:00 p.m. - 6:00 p.m. at the Renaissance Atlanta Waverly Hotel.
- All information will remain confidential to the judging team. If you have any questions, please contact admin@tie-atlanta.org.

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* Nominee information:

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* Nominee's assistant (if applicable)

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* Nominator information (if different than the nominee)

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* Your affiliation with the Nominee (if any):

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* Describe your company? (<less than 150 words)

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* What is your three to five year vision?

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* Do you have any seed, angel or other types of financial investment? If yes, please describe. (actual financial numbers are not required)

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* Please share your significant milestones? (please use bullets)

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* Describe your largest areas of growth? (less than 150 words)

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* Who are some of your most important customers?

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* What is your biggest challange? (less than 150 words)

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* List any additional information you would like for the judges to know? (Up to 200 words)

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* Describe your roles and responsibilities within the company? (<less than 150 words)

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* How have you contributed to the community? (Up to 150 words)

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* I CERTIFY THAT ALL INFORMATION IS CORRECT

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