EY Entrepreneurial Winning Women™

2017 application

In collaboration with:

How to apply• Complete and return the online application form below

in its entirety no later than June 9, 2017. Applications will not be accepted after the submission deadline.

• All fields are required. Descriptive fields should be limited to approximately 250 words each.

• All strategic and financial information provided is considered private and strictly confidential. It will be shared only with EY Entrepreneurial Winning Women program management and our panel of independent judges, all of whom are subject to confidentiality agreements.

• Please note that this online form does not include a “save” or spell-check feature. We recommend that you draft and save your responses offline before copying them into the form and submitting. You can download a PDF copy of the application here.

Eligibility requirements• The applicant must be the founding CEO of the venture and

at least a 51% owner at the time of application.* If there are other women co-founders, they may apply as a group if they meet the ownership criteria. Please note that if a venture is selected for the Entrepreneurial Winning Women program, the decision as to who ultimately participates and represents the company (whether it be only the founding CEO or the group) will be determined by the independent panel of judges. • *For those women who have sought outside

investment, the founding woman entrepreneur may still apply if she retains a majority ownership stake after deducting all outside investments.

• The applicant’s company must be less than 10 years old and have achieved at least US$2 million in annual sales in each of the last two years. Typical applicant company annual revenue ranges from US$2 million to approximately US$30 million.

• The applicant’s company must be headquartered in the US or Canada.

• Only for-profit businesses may apply.• Franchisors are eligible but franchisees are not.• Former EY Entrepreneur Of The Year® Award winners

are not eligible.• Applicants who are selected must be able to attend and fully

participate in the following two events: • Two-day EY Entrepreneurial Winning Women Orientation in

New York, October 4–5, 2017. • EY Strategic Growth Forum® 2017 in Palm Springs,

California, November 15–19, 2017. • Attendance at the Orientation and Strategic Growth

Forum is mandatory. Those unable to commit to both events may be better served not applying.

• Additional eligibility rules:• Only for-profit businesses may apply.• Franchisors are eligible, but franchisees are not.• Former EY Entrepreneur Of The Year® Award winners are

not eligible.

Criteria and selection• Applications will be reviewed by a panel of highly qualified,

independent judges representing successful entrepreneurs, investors and business leaders.

• The judges will be looking for entrepreneurs with the conviction, tenacity, plan and overall professional acumen to take a high-potential business and scale it into a market leader. Applicants are expected to demonstrate qualities needed to take full advantage of this opportunity, including the level of business sophistication needed to interact effectively with the EY entrepreneurial community.

For more information, contact EY.WinningWomen@ey.com or visit ey.com/winningwomen.

Think bigThank you for applying to the EY Entrepreneurial Winning Women program! We are committed to helping women entrepreneurs scale their businesses successfully and rapidly. By applying for Entrepreneurial Winning Women, you are applying for an award, as well as an ongoing program. Entrepreneurs who are selected participate in a customized leadership development program with activities designed to catalyze their companies’ growth by building and fostering critical relationships, enhancing leadership skills, expanding business know-how and providing increased visibility. Winners are welcome to remain engaged in the program for as long as they benefit.

Applicant information

Company information

Applicant name:

Company name: Industry:

Automotive Oil and gas

Cleantech Power and utilities

Distribution and manufacturing Real estate and construction

Financial services Retail and consumer products

Hospitality and leisure Professional services (please specify):

Life sciences (including biotech, medtech and pharma)

TechnologyMedia and entertainment

Other (please specify):Mining and metals

Co-applicant name (if applicable):

Company address:

Please succinctly describe your company and its principal business activities.

Title: Title:

Year founded:

Company website:

Cell phone: Cell phone:

Email address: Email address:

Assistant email address: Assistant email address:

Please provide name, title and company name exactly as you would want it to appear on announcements, programs or press releases.

Are you the founding CEO?

Are there other co-founders of the company? If so, please provide names, titles, contact information and percent ownership among all founders, along with their current roles in the business.

What percentage of the company do you presently own?Yes No

Think big

Financial dataFor the panel of judges, financial information is an important quantifiable indicator of success. The application will be considered incomplete, and the candidate will be disqualified from consideration if this section is not completed in full. This information will be kept confidential.

How have you financed your business? Please check all that apply:

Self

Venture capital

Family/friends

Public markets

Angel funding

Bank financing

Private equity

Other (please specify):

Please list all current investors and their ownership stakes:

Fiscal year-end (actual):

Please explain any unusual financial trends in the fiscal year-end financial information provided above, including any significant increases or decreases in revenue. If applicable, please also explain your intended path to future profitability if you are currently operating at a loss.

If yes, please provide a statement describing the matter and the current status:

Have you or your company been the subject of any investigation by a regulatory agency or governing or governmental body; any disciplinary action by any such agency or governing body; or any civil or criminal complaint?

Yes No

Most recent year-end Second most recent year-end Third most recent year-end

Fiscal year-end

Total employees

Annual sales

Income before taxes

EBITDA*

Total assets

Total equity

* Earnings before interest, taxes, depreciation and amortization. Please indicate negative numbers with a hyphen (“-“).

Personal statementPlease tell us the story behind your business and create a vivid picture of yourself as a woman entrepreneur who intends to run a market-leading business.

What inspired you to launch your company?

Describe your professional history prior to the creation of your company.

What are the major obstacles you have had to overcome in starting and/or growing the business? Share some of the personal and/or financial risks you have taken.

Personal statement (continued)Please tell us the story behind your business and create a vivid picture of yourself as a woman entrepreneur who intends to run a market-leading business.

Please describe the business model your company has successfully employed to date.

How do you plan to evolve your business in the next year? In the next three to five years? Be specific in describing your tactical goals and what it will take to achieve them.

What is your strategic vision for what your business can ultimately become? Where are you taking it? How big do you think you can scale and grow this company? (You may consider your answer in terms of revenue, job creation, market share, etc., as growth is an important objective for the program.)

Personal statement (continued)

Who are your most important competitors? How have you uniquely differentiated your business from their offerings?

Describe the culture of your company and the values that guide you as a leader. In addition, please describe your contributions and connections to community and/or philanthropic activities outside your company.

Do you have an advisory network? If yes, how well-developed is your advisory network?

Yes Long-standing and effective

Developing

No Just getting started

Personal statement (continued)

What gaps are there in your advisory network?

Why should you be chosen to participate in this program? What makes you uniquely qualified to capitalize upon this opportunity?

External advisors/references

Name:

Reference 1 Reference 2 Reference 3

Name: Name:

Title: Title: Title:

Phone: Phone: Phone:

Company: Company: Company:

Email: Email: Email:

Please provide contact information for up to three individuals who have assisted you in your business venture and who may serve as references. They may include board members, advisors, your banker, attorney, accountant or a valued investor who may be contacted by program management. They should not include any current employees.

PhotographIf selected for the 2017 Class of Entrepreneurial Winning Women, the applicant will be asked to submit one professional headshot photograph. The photo will be used for reference and production purposes related to the applicant’s progression within the program and for publicity purposes if selected. By checking the box “I agree” under the Applicant agreement, the applicant hereby confirms and represents that she has obtained any and all consents or waivers required in order for Ernst & Young LLP to use the photograph for the above-stated purposes.

Applicant agreement

Use of information — I understand that the information and materials provided in this application will be used by Ernst & Young LLP, the sponsors and collaborating organizations (as regards non-financial information) and the panel of independent judges for purposes of evaluating the application and creating a press release if I am selected to be one of the EY Entrepreneurial Winning Women. I consent to the use of such information for these purposes and hereby confirm and represent that I have obtained any and all authorizations or waivers required in order for Ernst & Young LLP, sponsors and judging panels to review and utilize applicant-provided information and materials in connection with the EY Entrepreneurial Winning Women program. I further consent to the use of such information for research, educational or any other purpose as long as such use does not divulge my identity or the identity of the company to any person other than the sponsors, the judges and their respective affiliates unless I authorize such use in writing. I agree that the deliberations of the panel of independent judges shall be confidential.

Release — In consideration of my participation in the EY Entrepreneurial Winning Women program, on behalf of myself and my heirs, executors and administrators, I hereby release and forever discharge Ernst & Young LLP and its affiliates, and the member firms of Ernst & Young Global Limited and their affiliates, and the partners, employees, agents, representatives, successors and assigns of each of the foregoing entities and the panel of independent judges from any and all liabilities, claims, actions, damages, costs or expenses of any nature arising out of or in any way connected with any information or materials submitted in connection with this application or with my participation in the EY Entrepreneurial Winning Women program, including any events, ceremonies or promotional activities related thereto, as well as the determinations of the panel of independent judges.

Limitation of liability — In no event will Ernst & Young LLP, its subcontractors, the member firms of Ernst & Young Global Limited or the panel of independent judges be liable to me, the company or any affiliates (or any respective successors or permitted assigns) for any consequential, incidental, indirect,

punitive or special damages (including loss of profits, data, business or goodwill) in connection with the EY Entrepreneurial Winning Women program, whether or not liability is based on breach of contract, tort, strict liability, breach of warranty, failure of essential purpose or otherwise, and even if Ernst & Young LLP or the panel of independent judges is advised of the likelihood of such damages.

Disputes — Any controversy or claim arising out of or relating to my participation in the EY Entrepreneurial Winning Women program shall be submitted first to voluntary mediation, and if mediation is not successful, then to binding arbitration in New York, New York, conducted in accordance with the CPR Rules for Non-Administered Arbitration as in effect on the date hereof. The arbitration panel shall have no power to award punitive damages or any other damages not measured by the prevailing party’s actual damages, and I expressly waive any right that I might otherwise have to obtain such damages in arbitration or in any other forum. The result of the arbitration shall be binding on the parties, and judgment on any arbitration award may be entered in any court having jurisdiction.

Use of photo, etc. — If I am selected as one of the Entrepreneurial Winning Women, I hereby give Ernst & Young LLP and its affiliates and the member firms of Ernst & Young Global Limited and their affiliates, and the partners, employees, agents, representatives, successors, assigns and those acting on its behalf of each of the foregoing entities the non-exclusive and transferable right, but not obligation, to use, edit, publicize and reproduce freely my name and other likeness, including, but not limited to, biographical data, picture, portrait, photograph, film, videotape, recordings of my voice or any written statements that I provide in connection with the EY Entrepreneurial Winning Women program, including, but not limited to, the development and publication of marketing materials, promotional publications, media publications and coverage, videos and other materials, whether such items are intended for an internal or external audience. I agree that no compensation shall be due me or my company or its principals and employees for such usage.

I have read this Application Form, understand its contents and represent that I am legally competent to sign this document on behalf of myself and my company and am not aware of any agreement with any other party that would conflict with the terms set forth herein. To the best of my knowledge, the information provided herein is true and complete. Please check the box to indicate your agreement and electronic signature, which is needed for the application to be valid.

I agree

How did you learn about EY Entrepreneurial Winning Women? Check all that apply.

US Hispanic Chamber of Commerce

Dell

Golden Seeds

Kauffman Foundation

Babson College University alumnae outreach (specify school):

National Association of Women Business Owners (NAWBO)

US Hispanic Chamber of Commerce Foundation

Women’s Business Enterprise National Council (WBENC)

News media

Women Presidents’ Organization (WPO)

Direct email solicitation

EY professional

Advisor (banker, attorney, board member, PR firm)

Other (please specify):

For questions or additional information, please contact EY.WinningWomen@ey.com.

All applications must be submitted online by Friday, June 9, 2017.

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About EY EY is a global leader in assurance, tax, transaction and advisory services. The insights and quality services we deliver help build trust and confidence in the capital markets and in economies the world over. We develop outstanding leaders who team to deliver on our promises to all of our stakeholders. In so doing, we play a critical role in building a better working world for our people, for our clients and for our communities.

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