EY

Entrepreneurial Winning Women

 

By applying for EY Entrepreneurial Winning Women, you are applying for an award as well as an executive leadership program. The entrepreneurs selected participate in a customized leadership development program with year-round activities designed to catalyze their companies' growth by building and fostering critical relationships, enhancing leadership skills, expanding business know-how and providing increased visibility. Winners are welcome to remain engaged in Winning Women activities for as long as they benefit.

How to apply:

  • Complete the online application form below in its entirety no later than June 28, 2013.
  • All fields are required. Descriptive fields should be limited to approximately 250 words each.
  • Applications will not be accepted after the submission deadline.
  • All strategic and financial information provided is considered private and strictly confidential. It will be shared only with EY Entrepreneurial Winning Women Program management and our panel of independent judges, all of whom are subject to confidentiality agreements.
  • Please note that this online form does not include a "save" or spell-check feature. We recommend that you draft and save your responses offline before copying them into the form and submitting. You can download a PDF copy of the application here.
EY Entrepreneurial Winning Women

For more information visit www.ey.com/ca/entrepreneurialwinningwomen or contact us at EY.WinningWomen@ey.com

  Applicant information:
 

Please provide name, title and company name exactly as you would want it to appear on announcements, programs or press releases.

   
  Name(s):
 
  Title:
 
  Company name:
 
  Company address:
 
Street: City:
State/Prov: ZIP/Postal code:
  Cell phone:
 
  Company website:
 
  Email address:
 
   
  Company information:
   
  Select your industry:
Automotive
Cleantech
Distribution and manufacturing
Financial services
Health Care services
Hospitality and leisure
Life sciences (including biotech, med tech, pharma)
Media & entertainment
Mining & metals
Oil & gas
Power & utilities
Real Estate and construction
Retail & consumer products
Professional services (please specify):

Technology
Telecommunications
Other (please specify):
 
 

 
  Please succinctly describe your company and its principal business activities.

 
 
Year company founded:


 
  Are you the founding CEO? Yes No
 
  Are there other cofounders of the company? If so, please provide names, titles, contact information and percent ownership among all founders, along with their current roles in the business.

  What percentage of the company do you presently own?

   
  Financial data:
 

For the panel of judges, financial information is an important quantifiable indicator of success. The application will be considered incomplete and the candidate will be disqualified from consideration if this section is not completed in full. This information will be kept confidential.

   
  How have you financed your business? (Please check all that apply)
Self
Family/friends
Bank financing
Angel funding
Private equity
Venture capital
Public markets
Other (please specify):
 

  Please list all current investors and their ownership stakes:

 
Have you or your company been the subject of any investigation by a regulatory agency or governing or governmental body or subject to any disciplinary action by any such agency or governing body or been the subject of any civil or criminal complaint?
Yes No

If yes, please provide a statement describing the matter and the current status.

 

    Fiscal year-end (actual)  
  Most recent year-end Second most recent year-end Third most recent year-end
Fiscal year-end            
Total employees            
Annual sales $ $ $
Income before taxes $ $ $
EBITDA* $ $ $
Total assets $ $ $
Total equity $ $ $
 

* Earnings before interest, taxes, depreciation and amortization

* Please indicate negative number with a hyphen ("-")


  Please explain any unusual financial trends in the fiscal year-end financial information provided above, including any significant increases or decreases in revenue. If applicable, please also explain your intended path to future profitability if you are currently operating at a loss.


  Personal statement:
 

Please tell us the story behind your business and create a vivid picture of yourself as a woman entrepreneur who intends to run a market-leading business.

What inspired you to launch your company?

 

 

Describe your professional history prior to the creation of your company.

 


What are the major obstacles you have had to overcome in starting and/or growing the business?
Share some of the personal and/or financial risks you have taken.


 

Please describe the business model your company has successfully employed to date.


 

What is your strategic vision for the future of your company?
Where are you taking it?
How big do you think you can scale and grow this company (you may consider your answer in terms of revenue, job creation,
market share, etc), as growth is an important objective for the program?


 

How do you plan to evolve your business in the next year? In the next three to five years?
Be specific in describing your tactical goals and what it will take to achieve them.

 


Who are your most important competitors? How is your business uniquely differentiated from their offerings?


 

Describe the culture of your company and the values that guide you as a leader.
In addition, please describe your contributions and connections to community and/or philanthropic activities outside your company.


 

Do you have an advisory network?


 

If yes, how well-developed is your advisory network?


 

What gaps are there in your advisory network?


 
Why should you be chosen to participate in this program? What makes you uniquely qualified to capitalize upon this opportunity?
   
  External advisors/references:
 

Please provide contact information for up to three individuals who have assisted you in your business venture and who may serve as references. They may include board members, advisors, your banker, attorney, accountant or a valued investor who may be contacted by program management. They should not include any current employees.


1.
 
  Name/title:
 
  Company:
 
  Phone:
 
  Email:
 

2.
 
  Name/title:
 
  Company:
 
  Phone:
 
  Email:
 

3.
 
  Name/title:
 
  Company:
 
  Phone:
 
  Email:
 
   

  How did you learn about EY Entrepreneurial Winning Women? Check all that apply:
  Committee of 200
Kauffman Foundation
National Association of Women Business Owners (NAWBO)
Women's Business Enterprise National Council (WBENC)
Women Presidents' Organization (WPO)
University alumnae outreach (specify school):

Print media
Broadcast media
EY professional
Direct email solicitation
Advisor (banker, attorney, board member, PR firm)
Other, please indicate:
  
  Photograph:
 

If selected for the 2013 Class of Winning Women, the applicant will be asked to submit one professional head-shot photograph. The photo will be used for reference and production purposes related to the applicant's progression within the program and for publicity purposes if selected. By checking the box "I agree" under the Applicant agreement, the applicant hereby confirms and represents that she has obtained any and all consents or waivers required in order for EY LLP to use the photograph for the above-stated purposes.

   

  Applicant agreement:
 

Use of information — I understand that the information and materials provided in this application will be used by EY LLP, the sponsors and collaborating organizations (as regards non-financial information) and the panel of independent judges for purposes of evaluating the application and creating a press release if I am selected to be one of the EY Entrepreneurial Winning Women. I consent to the use of such information for these purposes and hereby confirm and represent that I have obtained any and all authorizations or waivers required in order for EY LLP, sponsors and judging panels to review and utilize applicant-provided information and materials in connection with the EY Entrepreneurial Winning Women program. I further consent to the use of such information for research, educational or any other purpose as long as such use does not divulge my identity or the identity of the company to any person other than the sponsors, the judges and their respective affiliates unless I authorize such use in writing. I agree that the deliberations of the panel of independent judges shall be confidential.

Release — In consideration of my participation in the EY Entrepreneurial Winning Women program, on behalf of myself and my heirs, executors and administrators, I hereby release and forever discharge EY LLP and its affiliates, and the member firms of EY Global Limited and their affiliates, and the partners, employees, agents, representatives, successors and assigns of each of the foregoing entities and the panel of independent judges from any and all liabilities, claims, actions, damages, costs or expenses of any nature arising out of or in any way connected with any information or materials submitted in connection with this application or with my participation in the EY Entrepreneurial Winning Women Program, including any events, ceremonies, or promotional activities related thereto, as well as the determinations of the panel of independent judges.

Limitation of liability — In no event will EY LLP, its subcontractors, the member firms of EY Global Limited, or the panel of independent judges be liable to me, the company or any affiliates (or any respective successors or permitted assigns) for any consequential, incidental, indirect, punitive or special damages (including loss of profits, data, business or goodwill) in connection with the EY Entrepreneurial Winning Women Program, whether or not liability is based on breach of contract, tort, strict liability, breach of warranty, failure of essential purpose or otherwise, and even if EY LLP or the panel of independent judges is advised of the likelihood of such damages.

Disputes — Any controversy or claim arising out of or relating to my participation in the EY Entrepreneurial Winning Women Program shall be submitted first to voluntary mediation, and if mediation is not successful, then to binding arbitration in New York, New York, conducted in accordance with the CPR Rules for Non-Administered Arbitration as in effect on the date hereof. The arbitration panel shall have no power to award punitive damages or any other damages not measured by the prevailing party's actual damages, and I expressly waive any right that I might otherwise have to obtain such damages in arbitration or in any other forum. The result of the arbitration shall be binding on the parties, and judgment on any arbitration award may be entered in any court having jurisdiction.

Use of photo, etc. — If I am selected as one of the Entrepreneurial Winning Women, I hereby give EY LLP and its affiliates and the member firms of Ernst & Young Global Limited and their affiliates, and the partners, employees, agents, representatives, successors, assigns and those acting on its behalf of each of the foregoing entities the non-exclusive and transferable right, but not obligation, to use, edit, publicize, and reproduce freely my name and other likeness, including but not limited to, biographical data, picture, portrait, photograph, film, videotape, recordings of my voice, or any written statements that I provide in connection with the EY Entrepreneurial Winning Women Program, including, but not limited to, the development and publication of marketing material, promotional publications, media publications and coverage, videos and other materials, whether such items are intended for an internal or external audience. I agree that no compensation shall be due me or my company or its principals and employees for such usage.

I have read this Application Form, understand its contents, and represent that I am legally competent to sign this document on behalf of myself and my company and am not aware of any agreement with any other party that would conflict with the terms set forth herein. To the best of my knowledge, the information provided herein is true and complete. Please check the box to indicate your agreement and electronic signature, which is needed for the application to be valid.


 I agree

  Print the completed form
 

Upon completion of this online application and prior to submission, you are advised to print it for your records:




Thank you for applying to the EY Entrepreneurial Winning Women program!

For questions or additional information, please contact EY.WinningWomen@ey.com.

All applications must be submitted online by Friday, June 28, 2013.