Business Incubation Profile

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					           AABI Dr. Horiba Entrepreneur Award 2008
                          NOMINATION FORM

Name of Applicant Incubator
Country:                                      Postal Code:
Name of Representative:                       Title:
Name of Manager in Charge:                    Title:
Tel:                                E-mail:

Name of Applicant Entrepreneur/Company being nominated:
Prefix:                             Title:
Name of Company:
Country:                                       Postal Code:
Tel:                                E-mail:

                                  Application Guidelines

The application form consists of 2 parts, the basic information (in this page) and 4 question items (in
page 2-3) as follows: A. Entrepreneur Profile [35 points], B. Innovation, Product/Service, & Business
Model [25 points], C. Expansion in Business Scale & Outcomes [25 points], and D. Benefit / Special
Service Provided by Incubation Program [15 points].
Before filling out the form, applicants should refer to this guideline carefully, and then briefly
summarize information and clarify the points which each question item requires.
In each question item, the explanation should not exceed more than 300 words. Attaching files is
allowed if necessary, when the explanation exceeds 300 words, and needs detailed illustration for the
complicated business system, products, or technology. However, the applicants should make the best
efforts to describe the state and situation in each question item. Do not make just writing “please refer
to the file or the website” or “the information is in the attachment”.
At the end of each column, please indicate the number of words in the column by using the “Word
Count” function in MS Word, for example: ….(289 words). Please note that the numbers (i.e. 300, or
8,000) and the words in the graph or chart are also counted into the limit.
If the selection committee or the secretariat considers that the information provided by the applicant is
not sufficient or does not meet the requirements of nomination form, the secretariat may contact the
applicants via the association and possibly make request to rewrite the form.

Other notices:

* The company nominated in this form has to be a young entrepreneurial company either which is
  tenanted in the applicant incubator (current incubatee) or the one already graduated from incubation

* The information required in this form is very much related to one’s personal activities, particularly
  “Entrepreneurial Profile” in column A. Hence, it is highly suggested that the applicant entrepreneur
  should complete the form by himself/herself.

* The person who filled out this form must sign in the end. If the person is neither the applicant
  entrepreneur nor the management of the applicant incubator, please also designate the relation of
  applicant in the parenthesis.

* The AABI Dr. Horiba Entrepreneur Award prizes the best entrepreneur among Asia and the Pacific
  region, who utilized the business incubation program and made the remarkable growth, which can
  be a model for other entrepreneurs and business incubation programs. The AABI and association
  members make the best effort to dispatch information and collect nominations. But if the number of
  applicants did not reach the certain population, the secretariat may postpone the selection process.

* For the purpose of further development of incubation activities and research on successful model,
  the information collected in this form may be utilized as a case study. Upon any event of publicizing
  the entrepreneur- or company-specific information, the secretariat will contact the applicant
  incubator and entrepreneur beforehand.

                     Nomination Due: September 5, 2008 [Japan]

Basic Information of the Nominated Company

1    When was the company inception, month & year?

     Type of the company (university spin off?
     Spin off/out from a large firm? etc)

3    When was the company tenanted in incubator, month & year?

4    When graduated from the program, month & year?

5    Outline of the company: Describe briefly about the inception of the company and the businesses

                                                                The Year tenanted
6    Key Statistics                                                                     2008 (Present)
                                                                  in incubator
                                          Local Currency
                                          Local Currency
     Net Sales/Revenue (Turnover)
                                          Local Currency
     Net Income

     Number of Fulltime Employment

Note: Please refer to the exchange rate applied here:       1 USD =             (Date: day/month/year)

A. Entrepreneur Profile : (35 points)
 Describe the applicant’s entrepreneurial capabilities with specific reference to:
  - How he/she has been innovative?
  - How he/she is being engaged in entrepreneurial activities with great enthusiasm, in result, has reached
     an excellent accomplishment?
  - What challenges faced, mistakes made and how then have been overcome?
 Note: This item focuses on the entrepreneur himself/herself, not about the company.

                                                                                          (      words)

B. Innovation, Product/Service, & Business Model (25 points)
 Briefly describe the main features of the entrepreneurial activities and innovation with reference to:
  - How the company’s product or services differ from others?
  - What kind of problems to be solved and solutions to be provided?
  - How the product/service to be marketed?
  - What is the business model to make profits?
  - Any innovative aspects in company management, business process, or human resource development, etc.

                                                                                          (      words)

C. Expansion in Business Scale & Outcomes:             (25 points)
Describe the outcomes and process of the company growth with reference to:
 - The amount of fund invested,
 - Patents (Intellectual property) taken or applied for
 - Business deal with large firms and overseas - % of sales from export
 - Awards gained, if any
 - Exit goal, IPO etc.
 - Describe the increase in profit, turnover and number of employment with referring to Basic Information
 - A contribution or an impact on revitalization or growth in local economy, if any

                                                                                         (      words)

D.    Benefit / Special service provided by incubation program: (15 points)
Describe the benefit / effect given by incubation program, specially regarding:
   - The reason and background why and how got tenanted in the incubator
   - What kind of support services is provided and what is the one with the most value for growth?
   - How did the incubator make a difference?
   - How the company work with and being involved in the incubator activities, if any

                                                                                         (      words)

Name and designation of person filling this form

Name:                                    Date:


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