Community Service Application Form - MidCoast Business Awards

Introduction (optional)

The Community Service Award recognises Businesses and Individuals in the community that make a positive contribution to the community.

Conditions of Entry: (optional)

• Entrants must be located in the Barrington Coast region

• Entrants must be received by 5pm 10th December 2021

• Answer every question

• Submissions should not exceed 250 words per question

• All information remains confidential

Core Questions (optional)

These broad-based business questions are required to be completed by all entrants. This only needs to be completed once, regardless of how many categories entered. This section is not judged, however it provides a context in which your business operates and is used in the marketing of your business in relation to the Business Awards program.

Please describe what your business does?

0/250 Max words

Tell us the overall objectives of your business?

0/250 Max words

Tell us what winning these business awards would mean to your business?

0/250 Max words

How will your business act as a role model in the future?

0/250 Max words

Entrant Details (optional)

Business Trading Name

Business Display Name

(This is how we will refer to your business name in any marketing or promotions – for example, if you become a finalist it is how we will list your company name on the website, email marketing, finalist certificates and slides on the night etc.)

ABN

Date Established

Annual Turnover

Number of Full time employees

Entrant’s Name

Entrant’s Contact Phone Number

Entrant’s Contact Email

Entrant’s Contact Job Title

Business Postal Address

Category Entered

Business Chamber Status (optional)

I am a member of the Business Chamber

I would like to become a member of the Business Chamber

I hereby agree that:

1. The judge’s decision will be final.

2. To the best of my knowledge the information contained in this entry is correct and accurate at the time of submission.

Application Questions (optional)

Name of individual, organisation or business.

Entrant’s date of birth or date of establishment of Business or Organisation.

Provide a current profile of yourself or organisation including your scope of responsibilities, details of your role.

0/300 Max words

Provide an overview of the key features of your/ your organisation’s development strategy and projected outcomes for the future.

0/400 Max words

Describe the activities and initiatives you or your organisation have undertaken to contribute to the social, cultural or environmental wellbeing of the community.

0/400 Max words

Demonstrate how you/your organisation contributes to the local economy and community.

0/400 Max words

Outline the key challenges faced over the past 12 months and how you or your organisation has managed the impact of these challenges.

0/400 Max words

Describe the activities and initiatives you have undertaken to help the community (and or the business community).

0/400 Max words

Declaration (optional)

I declare that the information I have provided is true and correct at the time of entry. I confirm that I and my Businesses have met all the necessary licences and operational requirements for my business to operate in the MidCoast Council area. I further declare that I am not bankrupt or trading insolvent at the time of entry, nor in dispute with any other business, government agency or department at any level at the time of entry.

I understand that if circumstances change, concerning my own status or that of my business, I am obligated to inform the MidCoast Business Chamber and that this may at the sole discretion of the Judging panel, exclude me from these awards.

Acceptance

I agree that my name below will be as valid as a handwritten signature to the extent allowed by local law