entry form

Entry Form 2023

Submit the your entry form by 5pm on 7th July 2023.

Section A

Name(Required)

First Last

Email(Required)

Phone(Required)

Section B

Name of organisation(Required)

Address(Required)

Name of organisation Address City County Post code Country

Email(Required)

Phone(Required)

Section C

Date Business Established(Required)

Number of Employees(Required)

Describe your business(Required)

Section D

Section D

Choose your first category(Required)

Enter up to two categories in this awards

Category One(Required)

Why should you or your business win this category?(Required)

Please provide any additional information to support your entry:(Required)

Choose your second Category(Required)

Enter up to two categories in this awards

Category Two

If you are only entering one category please skip this section

Why should you or your business win this category?

Please provide any additional information to support your entry:

How do you or your business further the STEM sector in Wales?(Required)