This document provides instructions for completing an application form for awards that recognize women entrepreneurs. It outlines four categories for awards based on annual turnover amounts. The broad evaluation criteria include innovativeness, overcoming challenges, social good, employment generation, and scale of operations. When completing the application, only permanent ink should be used and it must be signed. Eligible participants must be Indian citizen women over 18 years old who have founded or led a business or organization with at least three employees.

1. 2011
INSTRUCTIONS FOR COMPLETING THE APPLICATION FORM
A. Objective of these Awards are:
To celebrate and recognize Women Entrepreneurs.
B. Award Categories:
Award Category Definition
Micro Enterprises A business whose annual turnover is between Rs. 1 Lakh and
Rs. 10 Lakhs
Small Enterprises A business whose annual turnover is between Rs. 10 Lakhs
and Rs. 2 Crores
Emerging Enterprises A business whose annual turnover is between Rs. 2 Crores and
Rs. 10 Crores
Medium Enterprises A business whose annual turnover is between Rs. 10 Crores
and Rs. 25 Crores
C. Broad Evaluation Criteria
Innovativeness of the concept
Overcoming socio economic/ familial challenges
Social good
Generating employment
Scale of operations
D. When completing the application forms:
Use permanent ink only – please do not use pencil
The entry form needs to be signed, at the space provided, by the participant (founder/ MD/
CEO, Chairman/ Director) and any of the following: senior employee, client or banker
E. Other important matters:
Participants should be Indian citizens, at least 18 years of age (as on January 1, 2011) and
entrepreneurial women who have founded/ successfully led companies/ cooperative societies/
sole proprietorships/ partnerships/ etc and currently have at least 3 workers/ members of staff
employed (excluding self).
The form can also be downloaded from our website- www.TiEStreeShakti.org
Please send the completed and signed form to
TiE Mumbai,
301, Turf Estate, Shakti Mills Lane, Off Dr E Moses Road, Mahalaxmi, Mumbai –
400 011. (Phone 022-42200100 -11 or 022- 64510062)
Each form can be used only for a single Entry
If you have any questions about the application form, please contact 022-42200100 -11 or
022- 64510062 or email us at info@tiestreeshakti.org
Please refer tothe Rules & Regulations document for additional guidelines on participation
-1- © 2011, TiE Stree Shakti

2. 2011
GENERAL & PARTICIPANT INFORMATION
2 Photos
Name of participant:
______________________________________________________________
Name of the participating organization:
______________________________________________________________
Type of organization:
Company Registered Society Partnership
Sole Proprietorship
Other (please specify): _________________________
Correspondence Address: ___________________________
__________________
___________________________________________________________________________________
City:_______ __________ State:__________________
Pin code:____________
Office Phone:
:____________
(STD code):_______ (No.):_______________
Fax No.:____________________ Mobile (0):_______________________
Email:__________________________________________
Website:_____________________________________
Designation of the participant in the organization
:______________________________________
Current Chief Officer Mr./ Ms.
____________________________________________________
-2- © 2011, TiE Stree Shakti

3. Presence of the organization’s activities in India (states)
:________________________________________________________________
Date of commencing operations (DD/ MM/ YYYY):____________ ______
_
Total amount of initial funding Rs._________________
Source of initial funding ___________________________
Industry of operation ___________________________
What does the organization do? What are its key product/ service or product offerings?
(in not more than 3sentences )
1. __________________________________________________________________________
____________________________________________________________________________
2. __________________________________________________________________________
____________________________________________________________________________
3. __________________________________________________________________________
____________________________________________________________________________
Who are the organization’s key customers? (in not more than 50 words)
__ __________________________________________________________________________
What is the progress of the organization?
(estimate) 2007 - 08 2008 - 09 2009 – 10
No. of Employees
No. of Customers
-3- © 2011, TiE Stree Shakti

4. 2011
APPLICATION FORM
A. Category applied for
Micro Small Emerging Medium
B. Give details about your entrepreneurial initiative for each of the following Criteria.
Additional details, if any, can be attached with this application form
Parameter Details
Innovativeness of the concept _____________________________________________
(How is your initiative new/ different?) _____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
-
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________
D. What socioeconomic/ familial challenges/ hardships did you face from the time you
-
started the organization? How did you overcome them?(in not more than 100 words)
.
(E.g. Societal boycott, family opposition, lack of funding, etc)
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
I accept the rules and regulations of participation. The information provided is correct to the best
of my knowledge and belief.
Name of Participant Title Signature
Email: ________________________________________________________________
Mobile (0):_______________________ Date:_________________________
-4- © 2011, TiE Stree Shakti