GLOBAL LEADERSHIP AWARDS - NOMINATION FORM

COMPANY PROFILE

Please fill in the nomination form below.

Name of Company

Address

Contact No

 Fax No

Website

Date Established
Country of Origin

Number of Countries Involved

No

Location Of Branches

Year Established
1
2
3
4
5

Name of Parent Company (if any)

Date Established

SHAREHOLDER'S FUND

Paid up Capital

 Authorised Capital

EXISTING EQUITY

Local Equity

 Foreign Equity

Name of Nominee

Date of Birth

Position

 Employment Period

Liaison Officer

Officer Position

Contact No

 Fax No

Email Address

COMPANY’S PERFORMANCE

RECOGNITION, AWARDS AND STANDARDS

No Name of Recognition
(for company, company’s employee, for nominee and companies’ services & products)Name of Awarding Body		 Name of Awarding Body Year Recipient of the Award Location
A Organisation & Management System (eg: ISO, Industry Excellence Awards and etc.)
1.
2.
3.
B Quality & Product Standards (Halal Certification, JIS, LAN, HACCP, CE Mark and etc)
1.
2.
3.
C Other Recognition, Award & Certification
1.
2.
3.

Specify any new initiatives/ innovation/ improvements taken for contribution to the Industry / Community / Company. (Please include Corporate Social Responsibility activities)

No Name of Campaign / Event / Activity Organiser Year Objective and Achievements Location
1.
2.
3.

Company’s Performance

No Year Total Revenue % of Growth based on previous year revenue Total Full Time Employees
1. 2010
2. 2011

DECLARATION BY PARTICIPANT

I, hereby declare that the information contained in this form is true and correct.

Mr/Mrs/Ms

Company Name

 Designation

Date

SUBMISSION OF FORM

Checklist for Applicants
Complete Application Form
Copy of Latest Form endorsed by the Register of Companies
Copy of Audited Financial Statement for the Year 2010 and 2011
Copies of relevant certificates of Recognition, Awards and Standards obtained
Company Profile including corporate chart
A set of Brochure / catalogue (if applicable)

Participant form and the relevant documents (Audited Financial Statements, product Catalogue / brochures, Trademark certificate for brand and other supporting documents) must be submitted by 15th March 2012 (Thursday, GMT + 08:00) to:-

Email :info@globalleadershipawards.com
Tel : +603 2035 5777
Fax : +603 2035 5797