NOMINATION FORM

Application Instructions

This is the nomination form that will present your company’s case for consideration to the CNME editorial team for inclusion in the CIO 100 Awards.

There are three parts to this form.

Part I asks for basic information about the nominated organisation.

Part II includes 7 multiple-choice, short-answer and essay questions about the nominated initiative.

Part III is composed of four multiple-choice and essay questions designed to measure business value of the nominated initiative.

1.1 CONDITIONS All nominees must agree to be featured in CNME magazine as part of its coverage for

CIO 100 Awards. This will appear in the February 2018 issue.

Nominations must be completed in full. Incomplete nominations will be disqualified.

Former CIO 100 honourees are encouraged to submit new systems/ projects/initiatives.

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Questions?For questions regarding the CIO 100 Award and application, please e-mail cio100@cpimediagroup.com

Part I. The Nominated OrganisationPlease answer all questions in this section. Completed applications will be given preference

over applications with missing information. For subsections 1 and 2, please provide information as you wish to have it appear in the magazine should your organisation be

selected as a CIO 100 winner.

1. Nominated Organisation Information

Legal name of nominated organisation:Headquarters address:Website address:

The nominated organisation is a (Select one)

o Public companyo Private companyo Non-profito Government organisation

2. Which primary industry/market does the nominated organisation serve? (Select one)

NON-COMPUTER RELATED INDUSTRIES

_ Aerospace/Defense contractor_ Agriculture/Construction_ Automotive/Transportation_ Business services/Consultant_ Education/Non-profit_ Finance/Banking/Accounting_ Government: Federal (including military)_ Government: State or local (including law enforcement)_ Health care/Medical services/Pharmaceutical/Bio-Tech_ Insurance_ Manufacturing_ Mining/Oil/Gas

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_ Media (publishing/broadcast)/Advertising/PR_ Real estate/Legal_ Utilities (oil, water, gas, etc.)_ Wholesaler/Retailer/Distributor

COMPUTER RELATED INDUSTRIES

_ Communication carriers (telecomm/data comm)_ Computer or network consultant/Data processing services_ Manufacturing: Hardware_ Manufacturing: Software_ Service provider (ISP/ASP/MSP/BSP/ESP/Web hosting)_ VAR/VAD/OEM/Systems or network integrator_ Wholesaler/Retailer/Distributor_ Other

Year organisation was founded:

2. Company SizeTotal number of employees in nominated organisation:

3. Executive Information CIO (or equivalent top IT executive)

Name:Title:Address:Phone:E-mail:

Contact information for CIO's assistant:

Name:Phone:E-mail:

CEO (or equivalent top business executive)

Name:Title:Email:Phone:

Contact information for CEO's assistant:

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Name:Phone:E-mail:

4. Additional InformationPerson submitting this application

Name:Title:Phone:E-mail:

If the nominated organisation is selected for a CIO 100 Award, is the IT executive listed in #3 above willing to participate as a speaker at the CIO 100 Forum and Awards?(Select one)

o Yes o No

Part II: Your ProjectFor multiple-choice questions, please select answers as instructed. Answers to essay

questions may be as long as is necessary to communicate information about your initiative that you would like the judges to consider. We suggest a range of 2100-7100 words,

depending on the question and its significance to your initiative.

Please be specific and use supporting data and whatever metrics are possible. Applications that also provide narrative examples about an initiative and its impact on the business –such how employees work differently, how customers interact with your company in new ways or

the impact the project has had in your market – have a better chance of winning than applications that merely summarise a project.

Describe your project or initiative. (Tell us what is it, what it does and when it began. Briefly describe how it works and its business purpose. Focus your answer on the specific initiative you are submitting for consideration. Please limit your response to 1000 words)

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2. Which business function primarily benefits from this project or initiative? (Select up to three choices)

_ Accounting & finance_ Human resources_ Asset management/maintenance_ Research & development/product development_ Manufacturing_ Inventory management_ Supply chain/logistics_ Marketing_ Sales_ Order processing/fulfillment_ Customer service/support_ IT operations_ Other

3. What is the primary business goal of the project?

_ Efficiency/Increased productivity_ Competitive advantage_ Business innovation_ Customer satisfaction_ Regulatory compliance_ Global operations_ Supply chain_ Business continuity_ Security/Privacy_ Other

4. Which technologies have been most important to executing the project? (Check all that apply)

Business Intelligence or Data Analytics

Business Process Management

Cloud Computing Services or Software as a service

Collaboration tools

Content or Document Management

Customer service or customer relationship management

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Databases or data warehouse

Enterprise Architecture

ERP

Mobile or wireless

Security technology

Social Media

Supply chain or logistics

Video conferencing and collaboration

Virtualisation

5. List the top three vendors whose products are most important to your project or initiative.

a.b.c.

6. Is your project or initiative a product or a service that is sold to outside organisations?

o Yeso No

If yes, please explain in more detail: ________________________________________________________________________

_______________________________________________________________________

7. What is innovative about your project or initiative?(The innovation may employ a new technology, or a new way of using existing technology. Summarise the most innovative aspects of your projects in a bulleted list. Then elaborate in as much detail as necessary about what makes your project novel. There is no word limit.)

_________________________________________________________________________

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Part III: Your Project's ImpactInformation in this section will be used to judge the significance and impact of the

nominated project or initiative.

1. How much money did you invest in the project? Please state all figures in U.S. dollars.

2. Which of the following best describes the current stage of your project?(Check one)

o Under developmento Piloto Deployed partiallyo Deployed fully

3. What is the time frame for the full payoff of the project? (Check one.)

a. 1 to 6 monthsb. 7 to 12 monthsc. 13 to 24 monthsd. 25 to 36 monthse. More than 3 yearsf. Project has already achieved its ROI

4. What are the specific business results generated by the project.

(Summarise the measurable business results of your project in a bulleted list. To answer, complete up to 25 word limit. Please elaborate with as much specific detail as necessary about the measurable business benefits and provide data to back claims (such as detailed RoI for financial value, increased market share, or additional revenue generated.) There is no word limit.

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