Extended Support for EQE Application Form Deadline: 02 June 2017 ADVICE Before completing the form please refer to the following documents which are available from the download section of http://www.epo.org/learning-events/eqe.html 1. The Regulation on the European qualifying examination (REE), Supplement to Official Journal EPO 2/2014, in particular Article 11. 2. The Announcement of the European qualifying examination 2018 (Official Journal EPO 2/2017). ELIGIBILITY To apply for the Extended Support for the EQE you must A. be permanently resident and working in one of the following countries. Czech Republic (CZ) Hungary (HU) Norway (NO) Poland (PL) Portugal (PT) Turkey (TK) AND B. have successfully enrolled for and registered to sit the EQE pre examination 2018, thereby meeting the admission criteria as set out in REE Art 11, in particular with regard to your university level technical qualification and work experience. Or you have already passed the Pre exam and will register for the main exams 2018. YOUR DATA PERSONAL DATA Title First name(s) Surname (as in passport) Gender Date of birth Place of birth Nationality Male Female PERMANENT RESIDENTIAL ADDRESS Street, house number Street, house number Town/City Province/ Region/State Country CORRESPONDENCE ADDRESS (only if different to above) We will post your books to your permanent address unless you instruct otherwise. If you have a preferred postal address please indicate it here. Street, house number Street, house number Town/City Province/ Region/State Country Extended Support Application Form for extended support for EQE 2018 Page 1 of 3 EMPLOYER`S DETAILS Company name Address Address Town/City Province/ Region/State Country www address Email address Telephone no. (incl. country code) CONTACT DETAILS Our communication with you will be primarily by email. Please indicate the email address and phone number you would like us to use. Your e-mail Your phone number (incl. country code) EQE EXAMS Paper Please indicate which exams you have already passed, which you will sit in 2018 and whether it is your first, second, third etc sitting. Year Passed To be taken at next 1,2,3 sitting etc. sitting (2018) Pre exam Paper A Paper B Paper C Paper D Previous Extended support Year of exam for which ES received 2016 Please indicate if you have already received Extended Support Books received 2017 EQEReg reference number DECLARATION I declare that, to the best of my knowledge, all information provided in this form is complete and accurate; I have not withheld or distorted any information. I understand that the request will not be granted if any information given is found to be untrue. I accept that the grant of my application is subject to the EPO's discretion. The EPO is not obliged to justify its decision regarding my application. I agree that the EPO may exchange relevant information regarding my participation in the Extended Support, with other external partners (e.g. postal services). Name ..............................................................................Place....................................................................... Signature.........................................................................Date........................................................................ Extended Support v2017.02.15 Application Form for extended support for EQE 2018 Page 2 of 3 NEXT STEP To finalise your application you will need the following documents: Proof of place of permanent residence Application form completed and signed Please submit the above 2 documents as a single pdf or fax to the following address: National patent office contact details: Mr. Ibrahim ULUTÜRK e-posta: [email protected] Tel: +90312 3031588 Faks: +90312 3031220 All documents must be received by DEADLINE: 02 June 2017 Extended Support v2017.02.15 Application Form for extended support for EQE 2018 Page 3 of 3
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