SAVCA Industry Awards Nomination Form
Please provide details (as appropriate) of your nomination below.
You can submit more than one entry, however, a form needs to be completed for each nomination.
Nominees must be companies that have, or have had, a substantial investment from a private equity/venture capital firm in the last two years.
Companies can nominate themselves, or private equity/venture capital investors can nominate their investee companies.


If you have any questions about completing this form please fill in the contact us form on the awards page

Nominating Company Details
Details of company/person filling out form/putting forward the nomination
Name of nominating company
Your answer
Your name and surname
Your answer
Your contact number
Your answer
Your email address
Your answer
Nominee information
Details of investee company
Name of nominated company
Your answer
In which country is the main operations of the nominee?
Your answer
What is the URL of the nominee's website?
Your answer
Category being entered (for details of categories, refer to awards page)
Name of private equity firm (if portfolio company is nominating itself)
Your answer
Date of initial investment
MM
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DD
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YYYY
Form of initial investment
Percentage interest *
Your answer
Amount invested *
Enterprise value of investee company at initial investment *
Your answer
Enterprise value at most recent valuation *
Your answer
Date of most recent valuation
MM
/
DD
/
YYYY
Internal rate of return for the lifetime of the investment *
Your answer
Is the investment:
If exited, please provide date and form of exit
Your answer
Which individuals from your firm have engaged with the investee and what role do they hold within your organisation (formal or other)?
Your answer
Please provide the following details for the life of the investment from the private equity/venture capital firm
At the start of the investment in portfolio company:
Number of employees
Your answer
Revenue (Rm) *
Your answer
EBITDA (Rm) *
Your answer
Operating profit margin *
Your answer
Number of operating locations
Your answer
At latest record date/exit date:
Number of employees
Your answer
Revenue (Rm) *
Your answer
EBITDA (Rm) *
Your answer
Operating profit margin *
Your answer
Number of operating locations
Your answer
Please provide the name and contact details of a suitable person at the investee company for us to engage with
Your answer
Award Motivation
Thinking specifically about the 24 month period leading up to the 15th April 2018, outline why the investee company should be considered by the judging panel for the award: highlighting key achievements made by the company during its relationship with the private equity/venture capital firm and explain, in detail, how this relationship was a causal factor in the investee company's success. Include aspects such as new markets entered; research and development outcomes; expansion and growth; new products and services (innovation); employee growth and job creation; impact on broader society (social and environmental); customer growth and feedback; current leadership and reputational factors; or any other differentiators/elements that make this company a prime example of the value private equity and venture capital investment brings.
Let us know in 500 words or less why your nominee is a worthy SAVCA Industry Award recipient
Your answer
*Financial information will only be utilised by SAVCA and Intellidex during the judging process in order to short list finalists and select award winners. As such, all figures shared will be treated confidentially. In certain instances, information submitted may be utilised for case study purposes, where consent is granted by all respective parties.
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