Tech for Good Nomination Form

Org Name

What is your organisations legal structure

Company registration number

What year was your social enterprise established?

Address

Main Contact Name

Position

Email Address

Phone Number

Facebook

Twitter

Instagram

Website

No of full time staff

No of part time staff

No of volunteers (FTE)

No of directors/trustees

What is your trading income for 2020 - 2021?

What is your other income for 2020 - 2021?

What is your total income for 2020 - 2021?

What is your trading income for 2021 - 2022?

What is your other income for 2021 - 2022?

What is your total income for 2021 - 2022?

Please give a short overview of the social enterprise, (no more than 200 words).

Please tell us about any changes you have made due to the impact of the Covid-19 pandemic, (no more than 200 words).

Please evidence how you identified a specific problem, (no more than 200 words).

Please explain how your solution was unique and creative, (no more than 200 words).

Please demonstrate how this has made a positive impact, (no more than 200 words).

Please evidence how you know your customers and stakeholders are satisfied, (no more than 200 words).

Please outline your forward looking strategy and future aim, (no more than 200 words).

Referee Name

Organisation

Relationship to nominee

Email Address

Contact Number

Referee Name

Organisation

Relationship to nominee

Email Address

Contact Number

12 + 15 =