NJ Tech Council 2016 Awards Celebration Nomination Form Nominee Information The NJ Tech Council's 20th annual Awards Celebration recognizes and celebrates tech and life sciences companies for their accomplishments in leadership, collaboration and innovation. The deadline for nominations is Friday, August 12th.This year it will take place on November 17th from 5:30 pm to 9 pm at the Palace in Somerset.More information at http://www.njtc.org/awards-celebration16/ Question Title * 1. Company Name Question Title * 2. FOR INDIVIDUAL AWARD NOMINATION ONLYIndividual's Name Question Title * 3. Address Question Title * 4. City Question Title * 5. State Question Title * 6. Zip Code Question Title * 7. CEO Question Title * 8. Phone Number Question Title * 9. Email Address Question Title * 10. Website Address Question Title * 11. Nomination For Award(May select more than one) BEACON OF LIGHT Award - Company that has developed a product that has improved personal health CONSUMER PRODUCT Award - Company has developed a transformational consumer product IMPACT Company of the Year - Over $25 million in revenues, market leader, employment growth and profit margin. (Suspense Award) INNOVATIVE Company of the Year - Company which, through innovation in products, services or business approach, has grown to become a serious competitor in the marketplace (revenues of $5 - 25 million). (Suspense Award) MARTINSON-BALLEN Technology Supporter Award - Presented to an Individual, currently active in the NJ tech community, who has demonstrated a significant commitment to the support and advancement of technology and innovation. KNOWLEDGE IS POWER Award - Awarded to an educational institution deserving of recognition for actively and consistently supporting the growth of the tech industry. LEGEND OF TECHNOLOGY Award - Presented to an individual who, over several decades, had a significant impact on the technology industry in NJ. LEGISLATIVE CHAMPION Award - A leader in the NJ Federal or New Jersey legislature deserving recognition for supporting NJ’s tech community. an extraordinary achievement impacting the technology industry in New Jersey. The individual has demonstrated achievements including, but not limited to, taking leadership role in the development of significant legislation resulting in a positive effect for the New Jersey technology industries. MASTER TECHNOLOGY Company of the Year - Long term growth and profitability; substantial impact on industry and market within the last ten years; advancement of industry standards and accomplishments as an outstanding corporate citizen. OUTSTANDING TECHNOLOGY DEVELOPMENT Award - Company or organization that utilizes or has developed a tech tool, process or service that made a substantial improvement on business metrics. PRIVATE Company of the Year - Market leader, unique product/service and strong financial performance. PUBLIC Company of the Year - Stock price appreciation, sustained growth and strong operating results. RISING STAR Award - Company has the strongest potential to emerge to become a leader in the tech industry ($1 million or less in revenue) TRAILBLAZER Award - Company has developed and/or introduced an ingenious, non-traditional and innovative way of doing business or creating a culture that produced a significant value and growth for the company. Question Title * 12. Why should the nominee be considered for this award? NOTE: Recommended type in Word (no paragraph breaks) copy and paste into nomination text box in 350 words or less. Question Title * 13. Is the Company publicly held? Yes No Question Title * 14. What year did the company go public? Question Title * 15. Stock Ticker Symbol Question Title * 16. Year Founded? Question Title * 17. Number of Employees? Question Title * 18. Revenue Question Title * 19. Company Headquartered in New Jersey YES NO Question Title * 20. External Service Providers:Please list below the individuals who may serve as references Attorney: Name: Company: Phone: Email: Question Title * 21. Accountant Name: Company: Phone: Email: Question Title * 22. Nominated by: Name: Title: Company: Address: Phone: Email: Question Title * 23. Acknowledgement: I understand that the information I provide on this application will be used by the sponsors and selection committee for the NJ Tech Council Awards Celebration and I consent to the use of such information for such purpose.DEADLINE FOR SUBMISSION IS MONDAY, AUGUST 8, 2016 by close of business. SUBMIT