Innovation Award Application Innovation Award 2016 Step 1 of 3 33% Innovation Award presented by Cherry Bekaert The Innovation Award is awarded to an organization that has been in business 2-5 years in the Richmond Region and has demonstrated "out of the box" thinking and a creative approach to any and all aspects of its business. This year, we are emphasizing three important industry sectors organically emerging in RVA: technology, health and industrial (manufacturing and distribution). We are looking for the most innovative new business in one of those three sectors. The deadline to nominate a business is Sunday, October 9th. The winner will be announced at our Annual IMPACT Awards Dinner November 3, 2016. When you are ready to begin filling out the form, please make sure you have the following information ready: Details about the nominee's growth and performance Specific innovations the nominee has brought to its particular industry Details about the nominee's exceptional potential Anything else you think we need to know about your innovative nominee Business InformationName of nominee business*When was the primary business founded?* To be eligible, the nominee must have been founded sometime between August 15, 2011, and August 15, 2014, to be considered 2 to 5 years old.Which sector does the business fall in to?* Technology Health Industrial Number of full-time employees (you may count multiple part-time employees as full-time equivalent.)Website Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code ContactName* First Last PhoneEmail* Evaluation CriteriaAll information you provide will remain confidentialThe new Innovation Award will celebrate businesses that are 2 to 5 years old that have shown amazing growth, innovation and potential.Please provide a brief overview of the nominee business.Business Growth*YearNumber of Employees During the 2 to 5 years that the nominee has been in business, please provide details about business growth. You may consider multiple part-time employees as full-time equivalent.Other FactorsWhat other factors should we consider that demonstrate the nominee's amazing growth since it was founded?Describe specific innovations the nominee has brought to its particular industry*Provide details of the nominee's exceptional potential.*What else do we need to know about the nominee?Accepted file types: doc, pdf, docx, ppt, pptx, xls, xlsx.Do you have media you'd like for us to review? Upload here!Should you be selected as a finalist, our evaluation team will arrange a site visit at your business location.Type your name*This counts as your electronic signature to authenticate your entry.