Media and Downloads
Queensland Leaders
Queensland LeadersDeveloping the next generation of International Business headquarted in Queensland

Member Nomination Form

Queensland Leaders is focused on developing the next generation of international businesses headquartered in Queensland. Each year Queensland Leaders will be selecting 15 leading private and unlisted public companies to participate in the 12 month Queensland Leaders initiative. Queensland Leaders will provide selected Members with the required skills, knowledge and networks to take their business to the next stage of growth and investment attraction. Members will receive personal mentoring from a leading public company executive while receiving on going education and mentoring from Queensland’s leading professional services providers. Is your business a Queensland Leader?

Benefits of being selected as a Queensland Leaders Member:

  1. The successful Queensland Leaders Members will be invited to participate within Queensland’s foremost entrepreneur’s business network to fast track their company’s growth over a twelve (12) month process;
  2. Members will undertake 30 knowledge workshops presented by leading practitioners on a broad range of professional topics essential to their success;
  3. Members will receive fifteen (15) mentoring sessions with leading professional services providers from the Queensland Leaders Sponsors Network;
  4. Members will have exclusive access to all ten (10) networking functions throughout the year, including over 30 key-note presentations from successful business leaders;
  5. Members will increase their personal and company profile through working with Queensland’s leading Government, industry and business leaders;
  6. Members will receive access to further capital and business opportunities.

Please complete the following details

The fields marked with an asterisk (*) are mandatory.

Part A: Background Company Information

1. Company Name *

8. Facsimile *

2. Trading Name

 9. Email *

3. Name of CEO *

 10. Postal Address *

4. Name of Contact *

 11. Head Office Address *

5. Position of Contact *

 12. Website Address *

6. Business Phone *

 13. ABN *

7. Mobile *

 14. Year Company Est. *

15. Select Relevant Industry Category *
Property / Construction Agricultural Services Services Industries Bio Technology
Creative / Entertainment Marine & Aviation Manufacturing & Processing
Retail &/or Brand Industries Information Technology Mining Industries Other

16. ASIC Number *

17. Details of company's Senior Management team *

Name Position Qualifications Years of Service

 

Part B: Company Details
1. Does the company have audited accounts? *
Name of Accountant:

Yes / No

2. Is the company looking to raise equity/debt capital in the next 12 months? Yes / No

3. What protected intellectual property does the company own? Please describe:

4. Locations of other company offices:

5. Number of Current Employees *
Full Time Part Time

6. Corporate Structure of Company *

7. Is the company a subsidiary or affiliate of another company? If yes, Please describe the relationship that the companies share:

8. In less than 50 words please describe the business: *

9. In less than 50 words please explain the attributes of the company that form a sustainable competitive advantage: *

10. In less than 50 words please explain the strength of the management team: *

 

Part C: Financial Details (Please provide amounts in $A) *

  2003 -2004 2004 - 2005 2005 - 2006 2006 - 2007
Yearly Revenue - Last 4 years
EBITDA
Net Tangible Assets

 

Rules of Entry

  1. Applications not containing the minimum level of requested data will not be accepted;
  2. Applicants are subject to ASIC and police checks;
  3. Further information and details may be requested of your company by the Queensland Leaders Judges, failure to provide this data may result in your company’s disqualification;
  4. The judging panel’s decisions are final and no discussion or correspondence will be entered into.

Eligibility

Queensland Leaders welcomes companies to apply if,

  1. They are market leaders in their field and are looking at internationalising their business;
  2. Have a head office or base the majority of their business in Queensland;
  3. They are either a Pty Ltd or unlisted public company;
  4. They have more than 4 years trading history;
  5. They have audited accounts for the previous 3 years.

Your Investment

Annual membership of Queensland Leaders is $12,500 (+GST), which includes access to all events, workshops, catering, etc.

 

Judging Criteria

The judging panel will consist of a broad range of individuals who each have extensive skills and experience in the funding and internationalization of companies. Key judging criteria in the selection process are listed below;

  • Personal and management skills, ability and ethics of the Principal;
  • Strategic direction and vision of the company;
  • Companies previous 3 year growth and financial performance;
  • Market insight, innovation and strategy;
  • Future national and international opportunity;
  • Potential to become a significant international listed public company.

The judges are looking for a select handful of talented entrepreneurs that have the innovation and drive to become the next Queensland Leaders.

Confidentiality

Information about a company’s financial position and history provided in your application will only be used for the purpose of selecting the Queensland Leaders Members by the designated judging panel. This information will be stringently treated as commercial-in-confidence. Company contact details may be provided to Sponsors and Partners of the Queensland Leaders network.

Privacy

For further information regarding the Queensland Leaders Privacy policy please refer to our online document on this website or contact the Queensland Leaders office on +61 7 3230 8087.

Declaration

By submitting this application, the applicant is declaring that:

  1. The information provided is true and correct;
  2. You agree to abide by the conditions and rules of entry of Queensland Leaders
  3. The company is free from legal investigation and is compliant with all Acts, Ordinances, regulations and by-laws, order, awards, licenses, permits, approvals and requirements in respect of the operations of that company.