Flying 40

General Information:

Company Name*

Address*

City*

State*

Zip*

Phone Number*

Fax

Email Address*

Website

CEO*

CFO*

Privately Held
Public
Exchange

Stock Symbol

Description of business

Secondary Contact Person:

Name*

Title*

Email*

Phone*

Revenue Information:

Category Group*
$1-10M revenues
$10M+ revenues

Gross revenues for 2008 fiscal year*
(calendar year 2008 or fiscal year ended July 1, 2008. If your company was founded after 2008 list gross revenues for your founding fiscal year.) $ Please submit specific figures at least to the tens of thousands for ranking purposes. Please eliminate revenues that reflect intercompany sales. The gross revenue figure above refers to 12 months ended: JuneDecember 2008 2009 2010 2011 2012

Gross revenues for 2012 fiscal year*
(calendar year 2012 or fiscal year ended July 1, 2012.) $ Please submit specific figures at least to the tens of thousands for ranking purposes. Please eliminate revenues that reflect intercompany sales. The gross revenue figure above refers to 12 months ended: JuneDecember 2012

Company Background Information:

Year Founded*

Did current CEO found company?*
Yes
No

Average total full time (or FTE) employees in:* FY 2008:
FY 2012:

Verification:

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