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2005 Technology Awards Gala
Geeks In Black

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Nomination Form
Please submit your nomination by
Friday, June 3, 2005
Award Category

CEO of the Year

Nominated By
Individual's name:

Title:

Company:

Address:

Phone:

Fax:

Nominee Information
Nominee's Name:

Title:

Company:

ME Address:

City:

Zip:

Telephone:

Fax:

Email:

Notable Accomplishments:
Please provide information on the individual's accomplishments to enhance Maine's technology industry. This executive must be the head of a Software/IT company headquartered in Maine that has been in operation at least three years, and whose company receives high ratings in sales growth, job creation in Maine, profitability, return-on-equity, new products and/or product upgrade releases, innovative technology applications, legislative activities pertinent to the IT industry and other civic and community involvement.

Please address each of the following points and limit response to 300 words for each bullet.
  • Describe the individual's leadership with regards to providing company vision and strategy, ability to attract and retain talent and promote individual employee's education and growth
  • Describe any challenges or issues overcome or resolved creatively
  • Describe values of integrity and ethics and how they are set within the organization

Please state in 25 - 50 words why this Individual should be the CEO of the Year. This statement may be: used as the description for the finalists within this category, posted on the MESDA site, read at the Awards Celebration and submitted in press releases.

References
List contact information for individuals who may be listed as references in this nomination submission. These references may or may not be contacted by the Judges.
Name: Title:
Company: Phone:
Name: Title:
Company: Phone:
Name: Title:
Company: Phone:

DEADLINE FOR SUBMISSIONS IS FRIDAY, JUNE 3, 2005.