2019 Emerging Company of the Year Award

Nomination Form

Life Sciences PA's Emerging Company of the Year Award recognizes a company or organization of 100 employees or less with significant operations in Pennsylvania, that has experienced significant growth and/or achievement in 2019, while contributing positively to its community and the overall life sciences business climate of the Commonwealth. The Emerging Company of the Year Award is evaluated based on the following – Revenue Growth, Business Plan Performance, Product Innovation, Community Impact, and Entrepreneurship + Leadership.

Please submit all nominations by 5pm on Monday, December 9, 2019. The winner will be announced at Life Sciences Pennsylvania's 2020 Annual Dinner, scheduled for March 19, 2020 at the Pennsylvania Convention Center in Philadelphia, PA.

Contact Melissa Callum at mcallum@lifesciencespa.org with questions regarding the Emerging Company of the Year nomination process or award.

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* 1. Nominator Contact Information

First and Last Name: *

Organization:

State:

Country:

Email Address: *

Phone Number: *

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* 2. Nominee Information

Nominee First and Last Name: *

Nominee Organization:

Product:

Address:

City/Town:

State:

Nominee Email Address:

Nominee Phone Number:

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* 3. 2019 Revenue Growth - Please provide information to support your recommendation, include any information that will help the selection committee evaluate the qualifications of the nominee (testimonials, statistical information, etc.).

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* 4. 2019 Business Plan Performance - Please provide information to support your recommendation, include any information that will help the selection committee evaluate the qualifications of the nominee (testimonials, statistical information, etc.).

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* 5. 2019 Product Innovation - Please provide information to support your recommendation, include any information that will help the selection committee evaluate the qualifications of the nominee (testimonials, statistical information, etc.).

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* 6. 2019 Community Impact - Please provide information to support your recommendation, include any information that will help the selection committee evaluate the qualifications of the nominee (testimonials, statistical information, etc.).

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* 7. 2019 Entrepreneurship + Leadership - Please provide information to support your recommendation, include any information that will help the selection committee evaluate the qualifications of the nominee (testimonials, statistical information, etc.).