The award recognises individuals and organisations for their consistent efforts to

advance and promote innovation and technology in our country.

Name of Company/ Organisation      

Business address      Tax Clearance Certificate: (Verified)      Owners/Directors: (Names on attachment)      Brief Product/Service description:      Contact Name      

Contact Number (cell and landline)      

Contact email address      

Criteria Information required Information requiredHas the enterprise developed and patented new technologies?

Specify product / patent details by name*Please provide supportive documentation

Provide a brief description

                 

What tools or technologies were used in the process and what makes this solution innovative?

Tools / technology platform

Motivation

                 

What are the benefits of the technology to business users, consumers and the environment?

Consumers / Business Users*Please provide supportive documentation

Environment*Please provide supportive documentation

                 

Organisational Size*Please provide supportive documentation

Turnover*Please provide supportive documentation

Number Employees*Please provide supportive documentation

                 

To what degree did the enterprise enter into collaborative partnerships with other institutions or relevant professional bodies?

Names Description of partnership or assistance provided*Please provide supportive documentation

                 

Please specify whether the youth or skills development in the technology sector had been involved in the enterprise or project*Please provide supportive documentation

Skills upliftment / training provided*Please provide supportive documentation

Net new jobs created per annum over the last 3 years*Please provide supportive documentation

                 

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Play Your Part AwardIn addition to the above Award category, the Play Your Part Award celebrates enterprises that

excel in displaying active citizenship and nation building in South Africa.

The objective of the Award is to lift the spirit of our nation by inspiring all South Africans to contribute towards positive change.

Criteria Information required Information requiredHow has your enterprise played a part in community upliftment?

Describe innovative community project(s) you were involved in

How did the project add value to the community?*Please provide supportive documentation

                 

How has your enterprise been involved with youth development / empowerment projects and programmes?

State youth projects and programmes you have been involved with

How did the project or program impact on youth?*Please provide supportive documentation

                 Has your enterprise upheld values that build the community and nation?

Please share values that have been practised within your enterprise and community

           

I have read and agree to abide by the rules and regulations as stipulated in the criteria, entry rules and terms and conditions for the South African Premier Business Awards 2013/14. I declare that all the information supplied by me is true and correct.

Name & Surname:     

Designation:      

Signature:      

Date:      

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