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VIA & SOLAR Vidarbha Udyog Gaurav Awards 2021
NOMINATION FORM
Form will take only 15 mins, 4 steps only
Step
1
of
4
25%
Name of Individual
*
Email
*
Phone Number
*
Category
*
Large Scale Industries (LSI)
Medium Scale Industries (MSI)
Small Scale Industires (SSI)
Woman Entrepreneur of the Year
Best Startup of the Region
Most Promising unit in Developing Districts (Nagpur Division) - I
Most Promising unit in Developing Districts (Amravati Division) - II
Best Exporter of the Region
Best Service Provider
Large scale manufacturing units operating in any district in Vidarbha.
Investment in plant or machinery and equipment is above 100 crores
Medium scale manufacturing units operating in any district in Vidarbha.
Investment in plant or machinery and equipment is between Rs. 10 crores to Rs. 100 crores
Small-scale manufacturing units operating in any district in Vidarbha.
Investment in plant and machinery and equipment is below Rs. 10 crores
All manufacturing units with at least one woman founder or Directly promoter in any district in Vidarbha
Manufacturing/Services unit with operations of less than 5 years in any district in Vidarbha.
Technology Driven or Disruptive Business. Preferred to have Startup India Certificate
All units operating or manufacturing unit in six districts in Vidarbha having least Gross District Domestic Product (GDDP).
Companies from - Gondia, Bhandara, Gadchiroli, Akola, Washim & Buldhana.
All manufacturing and service units operating in any district in Vidarbha, having min 25% export turnover.
All service companies operating in any district in Vidarbha. Entity having income more than more than 50% from services in his total turnover.
I confirm that,
I am authorized to submit this nomination on behalf of the organization mentioned below, &
The information provided in this nomination form is correct to the best of my knowledge.
The nomination submitted can be published in the VIA Enterprise and Knowledge portal
I certify that the information provided is accurate uptill the best of my knowledge and I have proof of all of them which I can demonstrate after being shortlisted
Joint applications, if any, can be filed individually but should also include a Letter of Support from the other parties involved especially
Accepted Terms
*
I have agreed to the Terms & Conditions
Hidden
Common Fields
Name of Organization
*
Type of Organization
*
Public Ltd.
Private Ltd.
Proprietorship
Partnership
LLP
Co-operative
Hidden
Turnover (Rs. Lakhs)
Turnover (₹ Lakhs)
FY 17-18
*
FY 18-19
*
FY 19-20
*
Hidden
Rate of growth in turnover(%)
Rate of growth in turnover(%)
FY 17-18
*
FY 18-19
*
FY 19-20
*
Hidden
Capital Expenditure (₹ Lakhs)
Capital Expenditure (₹ Lakhs)
FY 17-18
*
FY 18-19
*
FY 19-20
*
Hidden
Profitability (₹ Lakhs)
Profitability (₹ Lakhs)
FY 17-18
*
FY 18-19
*
FY 19-20
*
Hidden
Number of Employees (Permanent + Contractual)
Number of Employees (Permanent + Contractual)
FY 17-18
*
FY 18-19
*
FY 19-20
New ideas developed during pandemic followed by your organization. * Important/Noteworthy for the business. (Tick Any One)
Less than 2
Between 2 and 5
More than 5
Please provide this information in brief. (Optional)
This information will be required for second round
Kindly attach relevant documents / provide the data on your letter head with self certification.
Max. file size: 250 MB.
Hidden
Common Fields End
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Large Scale Industries
Innovations in Product/ Business Practices done in past 3 years. (Years - 17-18, 18-19 & 19-20)
*
Less than 2
Between 2 and 5
More than 5
Please provide this information in brief. (Optional).
This information will be required for second round
Kindly attach relevant documents / provide the data on your letter head with self certification.
Max. file size: 250 MB.
Sustainability/ CSR Initiatives taken in past 3 years & their impact. (Years - 17-18, 18-19 & 19-20)
*
Less than 2
Between 2 and 5
More than 5
Please provide this information in brief (Optional)
This information will be required for second round
Kindly attach relevant documents / provide the data on your letter head with self certification.
Max. file size: 250 MB.
Hidden
Medium Scale Industries
Innovations in Product/ Business Practices done in past 3 years. (Years - 17-18, 18-19 & 19-20)
*
Less than 2
Between 2 and 5
More than 5
Please provide this information in brief. (Optional)
This information will be required for second round
Kindly attach relevant documents / provide the data on your letter head with self certification.
Max. file size: 250 MB.
Sustainability/ CSR Initiatives taken in past 3 years & their impact. (Years - 17-18, 18-19 & 19-20)
*
Less than 2
Between 2 and 5
More than 5
Please provide this information in brief. (Optional)
This information will be required for second round
Kindly attach relevant documents / provide the data on your letter head with self certification.
Max. file size: 250 MB.
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Woman Entrepreneur of Year
Innovations in Product/ Business Practices done in past 3 years. (Years - 17-18, 18-19 & 19-20)*
Less than 2
Between 2 and 5 years
More than 5
Describe(Please provide this information in brief. (Optional)
Kindly attach relevant documents / provide the data on your letter head with self certification.
Max. file size: 250 MB.
Please describe your Growth Plan (in not more than 25 words)
Please describe your role and contributions made in growing your venture
*
In not more than 3 Bullet points
Hidden
Best Startup of the year
Hidden
Valuation
Valuation (₹ Lakhs)
FY 17-18
*
FY 18-19
*
FY 19-20
*
Please describe your Growth Plan (in not more than 25 words)
*
Innovations in Product/ Business Practices done in past 3 years. (Years - 17-18, 18-19 & 19-20)
*
Less than 2
Between 2 and 5
More than 5
Please provide this information in brief. (Optional)
This information will be required for second round
Kindly attach relevant documents / provide the data on your letter head with self certification.
Max. file size: 250 MB.
List Top 3 USP/ Uniqueness of Idea of your start-up
*
Hidden
Best Exporter
Hidden
Export Turnover
Export Turnover
FY 17-18
*
FY 18-19
*
FY 19-20
*
Hidden
% Increase in export turnover from previous year
% Increase in export turnover from previous year
FY 17-18
*
FY 18-19
*
FY 19-20
*
Hidden
Ratio of export turnover to Total Turnover %
Ratio of export turnover to Total Turnover %
FY 17-18
*
FY 18-19
*
FY 19-20
*
Hidden
Export Reach (no. of countries)
Export Reach (no. of countries)
FY 17-18
*
FY 18-19
*
FY 19-20
*
Hidden
Export Incentives received (Rs. Lakhs)
Export Incentives received (Rs. Lakhs)
FY 17-18
*
FY 18-19
*
FY 19-20
*
Innovations in Product/ Business Practices done in past 3 years. (Years - 17-18, 18-19 & 19-20)
*
Less than 2
Between 2 and 5
More than 5
Please provide this information in brief. (Optional)
This information will be required for second round
Kindly attach relevant documents / provide the data on your letter head with self certification.
Max. file size: 250 MB.
Sustainability/ CSR Initiatives taken in past 3 years & their impact. (Years - 17-18, 18-19 & 19-20)*
*
Less than 2
Between 2 and 5
More than 5
Please provide this information in brief. (Optional)
This information will be required for second round
Kindly attach relevant documents / provide the data on your letter head with self certification.
Max. file size: 250 MB.
List your Top 3 initiatives to increase exports (Tick Any One)
*
Less than 2
Between 2 and 5
More than 5
Please provide this information in brief. (Optional)
This information will be required for second round
Kindly attach relevant documents / provide the data on your letter head with self certification.
Max. file size: 250 MB.
Hidden
Best Service Provider
Hidden
Service Turnover (₹ Lakhs)
Service Turnover (₹ Lakhs)
FY 17-18
*
FY 18-19
*
FY 19-20
*
Hidden
% Increase in service turnover from previous year
% Increase in service turnover from previous year
FY 17-18
*
FY 18-19
*
FY 19-20
*
Hidden
Page 3
Bussiness Projection for next 3 years
Turnover Growth
*
0%-25%
25%-50%
>50%
Employment Growth
*
0%-25%
25%-50%
>50%
Nominator's Details
Name of organisation
*
Contact Person's Name
*
Designation
*
Contact Number
*
Email
*
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Country
Afghanistan
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Algeria
American Samoa
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Antarctica
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Cook Islands
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Sweden
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Tonga
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Tunisia
Turkey
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Virgin Islands, U.S.
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Signature
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