2016 Inner City 100 Application Form

About ICIC

ICIC is the leading authority on U.S. urban economies and the businesses that thrive there. Founded in 1994 by Harvard Business School Professor Michael Porter, ICIC supports public and private sector decision makers with analysis and programs that lead to urban investment, jobs and economic growth.

About the Inner City 100

For over seventeen years, ICIC has been recognizing and celebrating the fastest-growing businesses located in America's inner cities. The Inner City 100 list is published annually in FORTUNE and the winners are invited to attend the Inner City 100 Conference & Awards, where they gain management education from leading business school faculty and a chance to network with fast-growing urban businesses from across the U.S. Winners have reported meeting major investors and winning multi-million dollar contracts as a direct result of appearing on the list.

You can view last year's publication in FORTUNE here and last year's Inner City 100 Conference & Awards agenda here.

Program Benefits

Access to a national network of fast-growing businesses
National recognition in one of the country's preeminent business publications and the chance to be profiled in-depth by the award-winning editorial team
Education from leading business school faculty and CEOs
Resources to help your company market the award externally (to customers, prospective employees, potential investors, etc).

Eligibility for the 2016 Inner City 100
To be eligible, your company must:

Be an independently operated (not a subsidiary or division of another company)
Privately owned for-profit company that is not a bank or holding company
Be headquartered in an economically distressed urban area in the U.S.
Have ten or more full-time employees in 2015
Have a five year operating sales history (2011-2015) with sales of at least $100,000 in 2011 and $1 million in 2015

For more information about the Inner City 100 program, click here or email innercity100@icic.org.

The final deadline to apply is Friday, April 15, 2016.

Information provided on this application will be used by ICIC and FORTUNE to determine eligibility for the Inner City 100 program and list. Winning companies are selected at the discretion of ICIC.

Company Contact Information

Please note that all fields except "Address Line 2" are required. *This question is required.

Company Name
Year Founded
Address Line 1
Address Line 2
City
State
ZIP
Phone
Website

CEO Contact Information

Please provide contact information for your company's CEO or highest-ranking senior executive. The CEO will receive occasional high-level communications regarding important steps in the Inner City 100 process. *This question is required.

CEO First Name
CEO Last Name
CEO E-mail
CEO Phone
CEO Job Title

Primary Contact Information

Please provide a primary contact within your company for communications related to the Inner City 100. The primary contact will be the point-person for all communications from ICIC related to your company's application and, if applicable, its recognition on the Inner City 100 list (can be CEO or other employee). *This question is required.

Primary Contact First Name
Primary Contact Last Name
Primary Contact E-mail
Primary Contact Phone
Primary Contact Job Title

2016 Inner City 100 Recognition

Please provide the name(s) of the top ranking executive(s) that you would like ICIC to share with FORTUNE for recognition, in the event that your company is selected as a 2016 Inner City 100 award winner (e.g. CEO, President). Please note that final publication text is at the discretion of the FORTUNE editorial team. *This question is required.

Space Cell	Name	Title
Executive 1	Executive 1: Name	Executive 1: Title
Executive 2 (if applicable)	Executive 2 (if applicable): Name	Executive 2 (if applicable): Title

Business Description

In 1-2 sentences, please provide your company's mission statement or a brief description of its primary operations. *This question is required.

Employment Numbers

Please enter the number of employees your company had in 2015. *This question is required.

Full-time Employees
Part-time Employees
Temporary/Contractors (1099s)**

** 1099 contracted workers are self-employed individuals who receive a 1099 Tax Form, work within specific project and time constraints and invoice for completed work.

Annual Gross Revenues

Please input end-of-year revenue numbers in the following format: x,xxx,xxx without dollar signs. These numbers will be used to initially rank your company on the 2016 Inner City 100 list. If you are recognized as a finalist, we will request that you submit further materials to verify your submitted information.

The accuracy of self-reported numbers is an important part of our process and, while reported figures on the initial form don't need to be exact, we urge you to report these figures with care. *This question is required. This question requires a valid currency format.

2015
2014
2011

Your Perspective

What benefits do you expect to receive from participating in the Inner City 100 program? Select all that apply. *This question is required.

Educational opportunities for CEO and managers
Networking opportunities for CEO and managers
PR / marketing opportunities based on firm's status as an Inner City 100 winner
Opportunity to recognize staff contribution to success of the firm
Identification of new customers and / or suppliers
None of the above
Other Please enter an 'other' value for this selection.

How did you hear about the Inner City 100 program? Select all that apply. *This question is required.

Business Support & Networking Services (i.e. Chamber, Business Association, etc.)
Government
Community Development Organization
Program Alumni
Media
Financial Institution
None of the above
Other Please enter an 'other' value for this selection.

Referrals

List the specific source that first referred you to the 2016 Inner City 100, if any. Please note that referrals in this answer will also be used to help determine the 2016 Nominator of the Year award, which annually recognizes the partner that introduces ICIC to the most winning companies.

Referrer Organization/Company
Referrer First Name
Referrer Last Name
Referrer Email (if known)
Referrer Phone (if known)

Do you know of any other potentially high-growth inner city firms that you think would want to take part in the Inner City 100? If so, please nominate them using the 2016 Inner City 100 Nominations Form.

Confirmation Email

Please list the email address (can be same as above) at which you'd like to receive confirmation for this application submission. *This question is required.