SUBSCRIPTION FORM 2009
ORGANISATION
Name :
Mail address : Office address :
Postal code / city : Postal code / city :
VAT-number : Telephone :
IBAN/BIC number :
E-mail address :
Website :
Sector :
Employees : (number)
INVOICING INFORMATION (only fill out when data differ from above)
E-mail address :
And/or
At the attention of:
Mail address :
Postal code / city :
CONTACT INFORMATION
Ms/Mrs. Mr.
Titel(s) : Initials : Surname :
Department : Function :
Telephone :
E-mail address :
ADDITIONAL REMARKS
1. The settlement day for the organisation size is December 31st of the previous year. A year of
participation stretches from January 1st to December 31st. Participation in the EEI Platform during
the year is rated at the number of months still left. Membership will be prolonged automatically,
unless the EEI Platform office has received a letter of membership termination before October 1st.
2. Named amounts are excluding VAT and a single time administration fee of € 20,-.
3. The settlement day for the subscription (including whether being appointed as a Founding Partner)
is the day the EEI Platform has received your payment.
EEI Platform | www.eeiplatform.com | info@eeiplatform.com | +31 26 321 46 07
Brunelsingel 122 | 6841 KB Arnhem | The Netherlands

INVESTMENT FORM 2009
Your investment enables the EEI Platform to execute the activities and instruments, create
opportunities for your organisation and to realise the targets that are set. For those purposes, the
following investment model for 2009 has been created:
Organisation type: Size Investment
 Company (supplier/financial) < 250 employees € 750,00
250 – 1.000 employees € 1.500,00
> 1.000 employees € 3.000,00
 Company (receiver/user) < 250 employees € 250,00
250 – 1.000 employees € 500,00
> 1.000 employees € 1.000,00
 Company (other) to be discussed
 Government/policy European bodies € 3.000,00
National bodies € 1.500,00
Local and regional bodies € 750,00
 Educational organisation € 500,00
 Sectoral organisation < 250 members € 750,00
250 – 1.000 members € 1.500,00
> 1.000 members € 3.000,00
SUBSCRIPTION
By signing this participation form, your organisation states that:
1. the subscription and investment form has been filled out truthfully;
2. you are an authorized representative of the organisation mentioned above;
3. your organisation agrees with the terms and conditions of the EEI Platform.
Date : City :
Name : Country : Signature:
EEI Platform | www.eeiplatform.com | info@eeiplatform.com | +31 26 321 46 07
Brunelsingel 122 | 6841 KB Arnhem | The Netherlands