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US Pan Asian American Chamber of Commerce Southwest. 2014-2015. 10. ASIAN AMERICAN BUSINESSES. TOP. Application Form (Please print). Company Information Company Name Industry Headquarters Address City State Zip code

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  1. US Pan Asian American Chamber of Commerce Southwest 2014-2015 10 ASIAN AMERICANBUSINESSES TOP Application Form(Please print) Company Information Company Name Industry Headquarters Address City State Zip code Phone Fax Website Is Your Company: Public □ Private □ Are You A USPAACC-SW Member? Yes □ No □ • What is the Top 10 Asian American Business Award? • The Top 10 Asian American Business Award recognizes the 10 fastest growing Asian American-owned companies, based on percentage revenue growth over three years (2012 to 2014 for FYE between January and June). • Top 10 winners will be publicly recognized during our February 7, 2015 Lunar New Year event at Kirin Court Restaurantin Richardson. • What companies can apply or be nominated for the Top 10? • Owned (at least 51%) by one or more Asian Americans • Have at least $500,000 - $1,000,000 in revenue during 2012 – 2014 • In business for a minimum of three years • Headquartered in the U.S. Subsidiaries or divisions are ineligible (unless they have some public ownership and are separately traded) • Contribute to community How to apply? Companies may be nominated or may apply directly by sending to USPAACC-SW the completed Application Form with supporting documents, including the company’s last three FYE financial statements prepared by a third party. APPLICATION DEADLINE: Thursday, January 15, 2015 Mail, Fax, or Email the application to USPAACC-SW, 202 E. Border St. Suite144, Arlington, TX 76010; (682) 367-1393; (fax) (817) 469-9485; janine@uspaacc-sw.org CEO/Owner Information Mr./Mrs./Ms. Name Title Phone Fax Email CFO Information Mr./Mrs./Ms. Name Title Phone Fax Email Contact Person Information(if different from CEO) Mr./Mrs./Ms. Name Title Phone Fax Email “I certify that the financial information provided is accurate” CEO Name Signature Date Important: Financial statements prepared by a third party for FYI 2012, 2013, 2014 (January through June) must be submitted with this application. More Info. USPAACC Southwest • 202 E. Border Street , Suite 144, Arlington, TX 76010 (682) 367-1393 (Fax) • (817) 469-9485 • www.uspaacc-sw.org Janine Wong• (682) 367-1393 • janine@uspaacc-sw.org

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