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* At what email address would you like to be contacted?

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* Which business category would you like to apply for?

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* 2. Name of nominee?   
 

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* 3. Industry sector?

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* 4. Years in industry?

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* 5. Name of nominee’s company?

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* 6. Business sector?

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* 7. Year company established (if relevant)

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* 8. Estimated number of employees?

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* 9. Please indicate how many are full time and how many are contract/part time (if relevant)
 

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* 10. What is the nominee’s job title?

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* 11. Nominee’s position in company? (Please tick all that apply)

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* 12. If the nominee is an owner, partner, director or shareholder, what is the approximate turnover in Euro (figures should be same as those submitted to Companies Registration Office)?
 

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* 13. Briefly describe the nominee’s role, responsibilities, achievements to date and positions held that may be relevant. (max 200 words)

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* 14. What characteristics distinguish your nominee? (max 200 words)

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* 15. How has the nominee dealt with challenges in their business? Please cite at least one example, including the methods the nominee used to overcome the challenge. (max 200 words)
 

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* 16. How has the nominee’s business grown as a result of their efforts? Please use percentage terms if you’re not comfortable quoting figures. (max 200 words)
 
 

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* 17. Why should the nominee be considered a role model for other businesswomen? (max 200 words)
 

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* 18. What does the nominee expect to achieve over the next 12 months?
 
 

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* 19. Give three reasons why the nominee deserves to win this award. (max 200 words)

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* 20. IMAGE Magazine is an inspirational guide to the best of fashion, beauty, health, living and society. We’d appreciate your help in making it an even better read. Please answer the questions below:
 
What features do you read regularly in IMAGE (please tick all that apply)?
 

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* 21. Please fill out your own name and address.

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* 23. From time to time, IMAGE Publications have fantastic offers and promotions for IMAGE events, promotions and freebies. If you would prefer that we did not contact you about them, please tick “No”,

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* Independent News & Media PLC [INM] may send you information about future promotions, competitions and events. Your details will not be shared with any 3rd party. If you would prefer not to receive such information by email and/or text message, please tick No.

Terms and Conditions
Please note the judges reserve the right to consider candidates as nominees for other categories other than those they have specifically been nominated for. Only award winners will be contacted personally and acceptance of an award permits IMAGE Publications Ltd to use the winners’ names for promotional purposes. Entries can only be submitted online at www.image.ie and must reach us by Monday, October 28, 2013 at 5pm. This competition is not open to employees of IMAGE Publications Ltd or any of the sponsors of the Awards. A list of winners will be made available by sending an SAE to the above address. The judges’ decision is final and no correspondence will be entered into. IMAGE Publications Ltd does not accept any responsibility for late or lost entries.

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