Be Mogul 2015 Application Form

BE MOGUL 2015 APPLICATION FORM

CLOSING DATE- 29th MARCH 2015

ENTRY CRITERIA

This category is open to any African or African-Caribbean owned business operating for 12 months or more. The Applicant must be the business key owner. Please see terms and conditions.

Applicant Information:
First Name / Mr □Mrs □ Mr □Ms □ Miss□Dr □Other□
Last Name / Age
Country of origin / Citizenship
Home Address
Postcode
Business Information:
Please complete this information as you wish them to appear on any literature or publicity
Company Name
Address
Postcode
Type of Company / PLC□Ltd□Partnership □Sole Trader □ Public Sector□LLP□
Social Enterprise□Other □UTR No./Company No.______
Nature of Business / Sector
Business Start Date / No. of Employees
Annual Turnover (Sales) (2014) / £
Expected Turnover (2015) / £
Web address
Email / Contact No
Brief description of Business:
Academic Background
Please list any awards, accreditations, accolades or recognised achievements, giving a brief quote/testimony from client or any authorities (i.e. local councillor)
How did you get started in this business?
What has been the highlight of your career?
What is the best advice you have received?
What has been the greatest challenge you have faced in business and how have you overcome it?
What are the most crucial things you have done to grow your business?
Have you ever been made bankrupt, or been the subject of Debt Settlement, Arrangement or Personal Insolvency Arrangement under the Personal Insolvency Act 2012, made any arrangements with creditors or had any court judgements for debt made against you.
Yes □ No□
If Yes please fill in details below
If No, are you in the process of applying for bankruptcy for 2015 please give details below
Yes □ No□
If yes please provide details below
Have you ever been convicted of a crime?
Yes □ No□
If yes, explain number of conviction(s), nature of offense(s) leading to conviction(s), how recently such offense(s) was/were committed, sentence(s) imposed, and type(s) of rehabilitation.
…………………………………………
Have you at any time been disqualified from being a company director under the Company Directors Disqualification Act (1986)
Yes □ No□
If yes, please give details below
DECLARATION
I certify that the information provided and the statements made by myself are, to the best of my knowledge, true and accurate. I confirm that I have read full Terms and Conditions and agree to abide by them.
Name (please print): / Position:
Signature: / Date:
TERMS & CONDITIONS
By entering BE Mogul 2015, the entrant hereby consents to the following terms and conditions:
How to enter
You can nominate yourself, a friend, a family member, colleague, business associate and anyone you feel deserves recognition or can be nominated by someone else.
To nominate yourself – Complete Application Form and email it to
To nominate someone – Please send us the nominee’s name, contact details, company name and company website details to
Please attach a good quality head-and-shoulder photograph, no higher than 2mb in jpg format with your application.
Fully completed entries must be made online at or via email. No hardcopies will be accepted by the application closing date (29th March 2015)
Who can enter
Entry is open to any African or African-Caribbean business owner, whether they operate as a Limited company, sole trader or in partnership with others. BE Mogul is to recognise movers and shakers in the community, therefore joint applications will not be accepted.
Entrants can nominate themselves, a family member, colleague, business associate, and friend, or can be nominated by another person.
Entrants must be able to demonstrate that they are the key owner of the business and must have been in business for 12 months or more as of the application deadline.
Entrants must be either: legally entitled to stay in the UK, have a company registered in the UK, or be a sole trader.
Entrants must be 18 years or over.
An application form will need to be completed for each entrant. The information provided will be disclosed only to the judges, BE Mogul staff, and its key partners.
Any incomplete or improperly filled entry may be disqualified at the organiser's discretion.
The information provided in the application form will potentially be used for press releases and web content if the nominee is shortlisted,so please ensure it is factually correct – we will not be liable for inaccuracies published based on application content and changes may not be possible after publication.
By entering and providing information and details to the BE Mogul, you are consenting to your details being used in further BE Mogul marketing.
Judging
All entries will be judged on the information provided at the time of entry, additional amendments or comments may be accepted up until the deadline date (29th March 2015).
The shortlist will be based on the decision by an independent panel of judges.
Due to a large number of applications received, the judging panel are unable to provide individual feedback and only shortlisted candidates will be contacted.
Judges will be absent from any discussions where they have a vested interest.
All information provided to the judges will be used solely for the purposes of assessing the entries. Potentially sensitive information will not be made public.
BE Mogul reserves the right to withdraw any entry from the judging process at any time should they feel is inappropriate for any reason.
If it is found that any entrant has knowingly given false information on their application form, the BE Mogul reserves the right to withdraw their application at any time.
Shortlisting
If you are nominated and receive an official letter to apply to featured in the BE Mogul publication, you must reply within 14 days of receiving notice that you wish to/or not to continue with your application. Failure to do so will result in your exclusion from entry.
You will be officially informed whether or not you have been shortlisted to be featured in the BE Mogul2015 guide.
We will publish details of the shortlisted entrants to include profiles of projects/services, etc. using the information provided on the application form. We will not reveal names of those not shortlisted.
If you are shortlisted to be featured in the BE Mogul publication, you are encouraged to engage in advertising and promoting any material that you have been listed in (once our official embargo has been lifted) but you must state the year you were featured.

All information contained in this form will be treated as strictly confidential and will only be disclosed to the judges, BE Mogul staff and key partners, and used exclusively for the purpose of judging.