Nomination form – APEA Malaysia

Business Information

Industry*

Business Size*

Kindly indicate your annual revenue range below

USD 2 Million to USD 5 Million
USD 5 Million to USD 10 Million
USD 10 Million to USD 20 Million
USD 20 Million and above

Please indicate the exact amount here

Corporate Information

Company Name*

Date of Incorporation*

DD

MM

YYYY

Employee Size

Legal structure of the company

Private Limited
Public Listed
Government Owned/Linked

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Phone Number

Fax Number

Company Website

Participant Information

Nominee’s Name*

Designation*

Nationality*

Is the company founded by you?*

Yes
No

Years spent in Company

Years spent in Industry

Nominee Mobile No

Nominee Email

Contact Information

Secondary Contact Person’s Name

Secondary Contact Designation

Secondary Contact Person’s Mobile No

Secondary Contact Person’s Email

Financial Information

Investment (in local currency) spent on the following functions for the last financial year and as a percentage of sales. This includes payroll and all direct expenses. Documentary proof may be requested.

Financial Year

e.g. 2018 - 2019

Total Sales

Corporate Social Responsibility

Education and Training

IT Infrastructure and Software

Research and Development

Marketing and Branding

Supporting Documents

Please attach the following documents for audit review:

Latest Audited Accounts
Company Profiles
Testimonials / Letters of Recommendation (Optional)
Other Documents

File

Drop files here or

Acknowledgement

A non-refundable fee of RM 723.06 (with an 8% SST + 3% processing fee) will be charged for every submission of nomination to cover administrative and auditing expenses. We will contact you soon for further briefing on the next steps moving forward.

Master Entrepreneur Award (APEA)

Price: RM 723.06

Fast Enterprise Award (APEA)

Price: RM 723.06

Inspirational Brand Award (APEA)

Price: RM 723.06

Corporate Excellence Award (APEA)

Price: RM 723.06

Total

RM 0.00

Payment

Credit Card

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Declaration

*

I hereby declare that the information submitted herein and as supporting documentation are to the best of my knowledge, true and verifiable. I understand and agree that should any of the information submitted herein and / or any supporting documentation appended herein found to be factually incorrect or are designed to mislead the judges, my nomination will be null and void, and if I’ve been declared a winner, my award will be rescinded. I declare that I am not related to any staff of the Organizers or to any judges appointed by the Organizers (except normal business relationship, if any). I further declare that I have not attempted and will not attempt in any manner, monetary or otherwise, to influence the decisions of the Organizers and/or the judges. I also declare that my business and I have never been investigated for criminal or civil offences at any time in the past or present.

I Agree

Name

This field is for validation purposes and should be left unchanged.

SUBMIT NOMINATION

MY Nomination Form

Category

Business Information

Corporate Information

Participant Information

Contact Information

Financial Information

Supporting Documents

Acknowledgement

Declaration