HYDROGEN EUROPE SUPPORTERSHIP APPLICATION FORM
All applicants, by sending this form duly complete and signed,
1.
2.
Acknowledge they are aware of the content of the Bylaws of Hydrogen Europe and
Formally understand and accept the rights and obligations therein.
IMPORTANT
Together with this Application form, the Hydrogen Europe Secretariat will send you a digital copy of the Hydrogen
Europe Bylaws. Please send us back a signed copy (scanned PDF sufficient).
Supportership fees:
Company size
Annual fee (EUR)
Micro
1.000
Small
1.250
Medium
1.750
Large
2.500
For the purposes of this provision, the definition of small and micro-enterprises is the one provided by EC Law:
http://ec.europa.eu/growth/smes/business-friendly-environment/sme-definition/index_en.htm
Fee payment according to joining date:
Date of joining
% of fees to be paid
H1
Full payment (100%)
H2
50%
Supportership approval process:
Supportership applications are subject to the approval by the Board. Please contact the Secretariat to check the date of
the next meeting where your supportership can be confirmed.
Hydrogen Europe Secretariat, Avenue Marnix 23, B-1000 Brussels, Belgium
Tel: +32 2 540 87 75 l Fax: +32 2 513 05 77 l Email: [email protected] l Website: www.hydrogeneurope.eu
1. Applicant’s details
Name of company (full legal name)
Company registered address
Correspondence address (if different from above)
Company’s 9-digit Participant Identification Code (received
upon registration through the European Commission
Authentication Service to access the Horizon 2020
Participant Portal. More information here)
Affiliates1 eligible for funding under Horizon 2020 / FCH 2 JU
Company(ies)
Affiliates PIC no
Name of the company’s officer authorised to represent the
company in Hydrogen Europe and sign documents
Representative’s email
Representative’s telephone number
Representative’s fax number
1st replacement’s name
1st replacement’s email
1st replacement’s telephone number
2nd replacement’s name
2nd replacement’s email
1
As per Horizon 2020 Rules of participation, an “affiliated entity means any legal entity that is under the direct or indirect control of a participant, or
under the same direct or indirect control as the participant, or is directly or indirectly controlling a participant”. In practice, it is a sister of mother
company with a controlling stake of at least 50%. This data is provided for information only.
Hydrogen Europe Secretariat, Avenue Marnix 23, B-1000 Brussels, Belgium
Tel: +32 2 540 87 75 l Fax: +32 2 513 05 77 l Email: [email protected] l Website: www.hydrogeneurope.eu
2. Eligibility
Article 5 of the Grouping’s Bylaws states that to be eligible to be a supporter, companies must meet each of the
following criteria:2
1.
2.
(i) Companies established in a Member State of the European Union or (ii) companies having their registered
office, central or principal business location within a State (i) which is a contracting party to the European
Economic Area Agreement or (ii) which is an Associated or Candidate Country to the European Union;
Companies sharing and supporting the objectives of the FCH JU.
Does your company comply with Article 5.1? (i) (ii) (iii)
Yes
No
Please provide the name of the European Union, or the European Economic Area or Associate or
Candidate Country
Does your company agree with Article 5.2?
Yes
No
Yes
No
- Please provide an overview of the company’s fuel cell and/or hydrogen activities.
(Max. 10 lines)
Does your company support the objectives of the Hydrogen and Fuel Cell Joint
Undertaking?
2 Applicants are requested to complete the following questions, ticking the appropriate box and providing further
information where requested
Hydrogen Europe Secretariat, Avenue Marnix 23, B-1000 Brussels, Belgium
Tel: +32 2 540 87 75 l Fax: +32 2 513 05 77 l Email: [email protected] l Website: www.hydrogeneurope.eu
3. Company details
These questions aim at better assessing the profile of your company.
Large
What is your company’s size?
(please see cover page)
Medium
Small
Micro
Less than 10
Number of employees of the Company
10 – 49
50 – 249
250 or more
Less than €2m
Annual Turnover of your Company
(please tick as appropriate)
€2m to €9,999,999.99
€10m to €49,999,999.99
€50m or more
Less than €2m
Balance Sheet Total
(please tick as appropriate)
€2m to €9,999,999.99
€10m to €42,999,999.99
€43m or more
Is your company autonomous?
Yes
No
Hydrogen Europe Secretariat, Avenue Marnix 23, B-1000 Brussels, Belgium
Tel: +32 2 540 87 75 l Fax: +32 2 513 05 77 l Email: [email protected] l Website: www.hydrogeneurope.eu
4. Company details (continues)
1. Does your company have a holding of 25% or more in another company?
Yes
No
2. Is your company owned 25% or more by a company or public body?
Yes
No
3. If ‘No’ to question 2, is your company jointly owned by several linked enterprises or
public bodies?
4. Does your company draw up consolidated accounts?
Yes
No
Yes
No
5. If ‘No’ to question 4, are your company’s accounts included in the consolidated
accounts of another enterprise?
Yes
6. Is your enterprise owned between 25 and 50% by one or more of the following types
of investors, provided those investors are not linked?
Yes
No
No
If you answered ‘Yes’ to question 6, please indicate which of the following best applies to your company:
6.a Public investment corporations, venture capital companies, or business angels have stakes of less
than €1.25m.
6.b Universities or non-profit research centres fund your company.
6.c Institutional investors3, including regional development funds apply.
6.d Autonomous local authorities with an annual budget of less than €10m and fewer than €5.000
inhabitants, fund your enterprise.
3 “The European Commission does not formally define the concept of ‘institutional investors’. They are usually seen as investors which trade large
volumes of securities on behalf of a great number of individual small investors and which have no direct involvement in the management of the
firms they invest in. Mutual funds or pension funds, for instance, may be considered as institutional investors.”
Hydrogen Europe Secretariat, Avenue Marnix 23, B-1000 Brussels, Belgium
Tel: +32 2 540 87 75 l Fax: +32 2 513 05 77 l Email: [email protected] l Website: www.hydrogeneurope.eu
5. Hydrogen Europe Supportership fees
Invoicing address
(if different from company address)
Invoice contact name
(if different from official representative):
VAT number
Purchase order number
(if necessary)
Yes
Does your company accept PDF invoices?
No
6. Hydrogen Europe Committees
Please state which Committee your company is willing to participate in the status of passive participant, without the
right to participate in the production and delivery of Committee documents.
Transport Pillar I – Committee 1: Fuel Cells for Vehicles
Transport Pillar I – Committee 2: Transport Infrastructure
Energy Pillar II – Committee 3: Energy to Hydrogen
Energy Pillar II – Committee 4: Fuel Cells for Power
Energy Transition Solutions (Cross-cutting) – Committee 5
7. Signature
Signature of the authorized officer
representing the company in
Hydrogen Europe
I hereby confirm that the above mentioned company is
financially viable earning sufficient revenue to cover
Hydrogen Europe membership fees.
Company’s stamp (if feasible)
Date
Hydrogen Europe Secretariat, Avenue Marnix 23, B-1000 Brussels, Belgium
Tel: +32 2 540 87 75 l Fax: +32 2 513 05 77 l Email: [email protected] l Website: www.hydrogeneurope.eu