EuroAsia IC Industry Awards

Your Details:

Name:
Job Title:
Company:
Address:
Phone:
Fax:
Email:
Company Website:

Your Nomination:

Company/individual to be nominated:

Contact Person:

Select a category for this nomination from below:

Create a title for this nomination (e.g.: “X product/process from Y company”):

Please complete nominee details below:

Job Title:

Company:

Address:

Phone:

Fax:

Email:

Company Website:

Nominated product/process description (minimum 200 words):

Give reasons why this entry should win an award:

Testimonial/Reference *
If possible please provide a reference or testimonial from a customer or client (this may help your entry but is not essential, as we understand companies have confidentiality clauses)
*Not essential

Endorsement 1:
Endorsement 2:

OPTIONAL Please upload a picture of the product and/or person nominated: