2024 Super 60 Submission Form - Growth

Recognizing revenue growth over a consecutive three-year period.

ELIGIBILITY FOR GROWTH AWARD

Independent and privately-owned companies.
Revenues of at least $1 million in the last fiscal year.
Based in Hampden or Hampshire Counties..
At least 5 full years in business.
Companies may be nominated by bankers, attorneys, financial services, accountants, etc. or self-nominated.
The nominating organization is responsible for the completion of this form and for informing company of nomination if not self-nominated.
Financial Institutions must provide total asset figures. If your company’s fiscal year ends other than December 31, please submit revenues for the last three full fiscal years. The revenue figures reported to the Springfield Regional Chamber Super 60 Committee on this form are the same revenue figures reported by the company under generally accepted accounting principles.

Fields marked with an * are required.

Nominee Information
Tell us about the Organization you are nominating.

Name of Organization Being Nominated *

Year Founded

Product/Service *

What product or service does this organization provide?

Address Line 1 *

Address Line 2

City *

State *

Postal Code *

Nominee Organization Description (100 character limit)* *

*will be included in the Super 60 event program if selected as a winner.

Nominee CEO/President Information
Tell us about the CEO/President of the Organization you are nominating (please specify in the Title field if this somebody other than the CEO/President).

First Name *

Last Name *

Title *

Email *

Phone *

Submission Information

FY 2021 Net Operating Revenue *

FY 2022 Net Operating Revenue *

FY 2023 Net Operating Revenue *

Officer of Nominated Company

Independent Certified Public Accountant

Name of Accounting Firm

Kindly provide any additional pertinent details in relation to your nomination.

20MB max

Nominator Information
Tell us about yourself.

Nominator Name *

Nominator Company *

Nominator Title *

Nominator Email Address *

Nominator Phone Number *

2024 Super 60 Submission Form - Growth

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Springfield Regional Chamber