Nominee’s Name:

Name of Business:

Title/Position:

Business Address:

Home Address:

Telephone: (Business)(Fax)(Home)

E-mail address: NAICS Code:

Sponsor’s Name:

Title:

Business/Organization:

Address:

Telephone: (Fax)E-mail:

Give a brief one-paragraph description of the nominee’s business:

Give a concise statement clearly describing why the nominated individual should be recognized with this SBA Small Business Award:

Date and Type of SBA Assistance:

(Please note: SBA Assistance is not required for a nominee to be eligible for this SBA Award Category.)

2015 SBA Small Business Awards – Guam Branch Office Home-Based Business Champion Page 1 of 4

I.Volunteering time and energy to improve the conditions for home-based businesses.

II.Engaging in entrepreneurial training, policy development efforts, or financial or business planning specifically tailored for home-based businesses.

III.Demonstrated interest in home-based business as an owner or former owner.

IV.Measurable accomplishments in advancing home-based businesses, such as adoption of public policy or expansion of a program.

V. Other significant contribution and accomplishments demonstrating the nominee’s merit as an effective advocate for home-based businesses in the business community.

Additional Information

The prestigious Small Business Awards honor the outstanding small business men and women who demonstrate excellence and achievement. All nominees and nominees’ businesses must comply with state and federal regulations regarding labor, immigration, civil rights, taxation, and other applicable regulations. Any financial information provided as required for the nomination will be held in strict confidence by the selection committee and SBA. By submitting the completed nomination form, the nominee certifies that, to the best of his/her knowledge, the information provided is correct and the business has complied with regulations, as stated above.

Please note that SBA will accept only one nomination per person or business entity within an award category. If a duplicate nomination is received, the nomination submitted to GBO at the earliest time will be considered for the award. Individuals and businesses may only be nominated in one award category each year. SBA winners who were honored in this award category prior to the 2010 awards (more than five years ago) may be nominated if they continue to meet all criteria for eligibility for the award.

A Home-Based Business Champion of the Year will be selected from qualified candidates. At least two headshot/portrait-type colored photo images of the winner, their business operation, and at least one photo with/of their nominator will be required for publicity and the Awards presentation. The photos may be in hard copy or digital format. These items will be due in the Branch Office in early February 2015.

2015 SBA Small Business Awards – Guam Branch Office Home-Based Business Champion Page 1 of 4