TiECON SE 2013 Awards - VC of the Year

"VC of the Year" - 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 VC of the Year award must meet the following specific criteria:
- Must be a corporate formed VC with an active fund.
- VC does not need to be based in TiECON SE region.
- Total deployed capital in TiECON SE region in 2012 will be considered.
- History of companies receiving additional funding rounds and/or that are profitable
- Industry focus
- Experience being an entrepreneur(not just investment banking background)

- 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:

Name: *

Company: *

Title:

Email Address: *

Phone Number: *

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* Nominee's Assistant (If applicable)

Name:

Email Address:

Phone Number:

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* Nominator information (if different from nominee)

Name:

Company:

Phone Number:

E-mail Address:

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* Your affiliation with the Nominee (if any):

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* DESCRIBE YOUR COMPANY(Up to 150 words)

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* DESCRIBE YOUR ROLE AND RESPONSIBILITIES IN THE COMPANY (Up to 150 words)

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* PLEASE SHARE YOUR SIGNIFICANT MILESTONES (Up to 200 words)

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* HOW HAVE YOU CONTRIBUTED TO THE COMMUNITY? (Up to 200 words)

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* LIST ANY ADDITIONAL INFORMATION WE SHOULD BE AWARE OF - INNOVATION, SPECIAL CIRCUMSTANCES, UNIQUE CHALLENGES, ETC. (Up to 200 words)

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* I CERTIFY THAT ALL INFORMATION IS CORRECT

Yes