Hot Tip: 

We've been experiencing some technical difficulties from time to time.  In order to avoid lost data: 

1.  Save the narrative

portion (e.g. Business Description, Success, etc) of your application in a Word document as a backup. 

2.   Cut and paste from your Word document into the application.  


Top 100 Minority Business Enterprise Award
Application Form

Deadline for Applications:

March 15, 2012

Applicant's Data:
Business Owner 1:    
Last Name:
First Name:  
Title:  
Business Owner 2:    
Last Name:  
First Name:  
Title:  
     
Business Name:  
Address:  
Address2:  
City:  
State:  
Zip:  
County:  
Phone:  
Fax:  
Owner's Email:  
Assistant's Email:  
Website:  
     
For Administrative Purposes Only. It will never be published:
Home Address:  
Home City:  
Home State:  
Home Zip:  
Home Phone:  
Check here if you prefer correspondence to be mailed to your home.
Otherwise, mail will be sent to your office.
     

Business Information:
Year Established:  
State Established:  
Industry Sector:  
If you selected OTHER please explain:  
     
Headquarters Location: (if address is different from above):
HQ Address:  
HQ City:  
HQ State:  
HQ Zip:  
     
Business Classification:
(select all that apply)

(PC crtl+click)
(Mac command+click)		  
     

***The following five sections are critically reviewed by our judges in determining the winners:***
Business Description:

Using the following format, please describe your business in 100 words or less.  The descriptions of the TOP 100 winners will be published in the Top 100 MBE Magazine.   Please start your description with the following sentence.  

The (name of your company) is/provides……       Click here for a description example.
  
 
   
Business Success and Contributions:

(Please tell your story in 200 words or less, including  (a) why you became an entrepreneur, and (b) your proudest accomplishment as a business owner.  This information is used in the judging process and will be published in the Top 100 MBE Magazine
  
 
   
Professional Affiliations, Achievements and Awards:
(This information is used by the judges)

List all current or previous business achievements, awards and affiliations with professional organizations. 
  
 
   
Community Service:
(This information is used by the judges)

Include current or previous service rendered to your community.
  
 
   

CUSTOMER RELATIONSHIPS:

A client reference letter is required as a part of the judging process.  Please submit only one (1) letter.  Your letter must be received no later than August 23rd.    There are two ways to submit your letter.
  
(1) Electronically  have your client submit a signed letter to applicant@top100mbe.com -  please have your client place your name in the subject line .  
OR  
 (2) Submit via regular mail to:

Sharon Pinder c/o Top 100 MBE Awards
6030 Daybreak Circle   Suite A-150#155
Clarksville, Maryland 21029

  
Client Name:  
Client Title:  
Client's Business Name:  
Client Address:  
Client City:  
Client State:  
Client Zip:  
Client Phone:  
Client Email:  
     

Research Data:

The following information will never be published.  It is supporting data to help the judges ascertain the scope of your business and to be used for special recognition of awards.  We also use the data as a collective source for our internal research purposes.
Number of employees excluding yourself:  
2007-2009 average annual revenue:  
Gender:  
Ethnic Classification:
(e.g. African American, Asian, Latino)		  
Business Formation:  
     

Required:

  
Affidavit:I certify that all information contained in this application is complete and correct.
 
   
Date:  
     
To ensure the correct pronunciation of your name, please provide the phonetic spelling for the announcer.
  
Name Phonetic:  
     

** Please include a recent head and shoulder photograph with your application.  The minimum size of your photo is 4x6 and resolution should be 300 dpi.  Send your photo to applicant@top100mbe.com .  Please place Photo and your name in the subject line.
Applications must be received no later than March 15, 2012.  All incomplete applications will be removed from the final judging process.  Winners will be notified in September.