Jan 1, 2013 - Signature : ... Requested additional documents and data ... A document in which the applicant proves its p
The European Platform of Women Scientists is a network of networks of women scientists and of those promoting women scientists across Europe. Membership Application Form Please fill in in CAPITAL LETTERS Name of Organisation/Network/Individual Applicant:
Requested Membership (annual fee): Full Member (120€) (see page 2) Associate Member (100€) (see page 2) Individual Supporting Member (please specify which type) Professor (30€) (please specify) Researcher (30€) (please specify) Student (no fee) (please specify) Supporting Organisation (see page 2) Address:
Telephone Number/ Fax Number: E-mail: Website: Research Area(s) Covered:
Is your organisation/are you a member of any other network(s)?
To be completed by applicants for Full or Associate Membership: Name(s) and position(s) of authorised representatives: 1. 2. How many members do you represent? To be completed by applicants for Individual Supporting Membership: Affiliation: Position: I accept EPWS’ Terms and Conditions Name _______________________ Date _______________________
(please read page 4)
Signature : ___________________________ Place: ___________________________
Your personal data are for EPWS internal use only and will not be transmitted to third parties.
1 Jan 2013
The European Platform of Women Scientists is a network of networks of women scientists and of those promoting women scientists across Europe. Requested additional documents and data For Full Members: 1. Documentation of the past record as well as the work programme of the applicant organisation where appropriate and available. 2. A signed declaration whereby the applicant accepts the Association’s purpose and aims, key policy statements, joint declarations and rules and procedures as decided by the General Assembly (see page 3, top). 3. The Statutes of the applicant organisation, together with a 2nd signed declaration (see page 3, bottom). 4. A list of the members of the applicant organisation, and of their addresses where appropriate, and for the exclusive perusal of the Executive Committee,. Strict confidentiality will be ensured. 5. A document in which the applicant proves its power of representation and the fact that the association is structured and managed in a democratic way. 6. Financial report for the last financial year, if possible.
For Associate Members: Points 2 and 5 above For Individual Supporting Members & Supporting Organisations: Point 2 above
For Supporting Organisations: Please choose your category and annual contribution: Corporations
Platinum ≥ 10.000€ Gold ≥ 5.000€ Silver (SMEs) ≥ 2.000€
Foundations
Platinum ≥ 5.000€ Gold ≥ 3.500€ Silver ≥ 2.000€
Universities, Research Institutes, Other
Platinum ≥ 4.000€ Gold ≥ 1.500€ Basic ≥ 500€
2 Jan 2013
The European Platform of Women Scientists is a network of networks of women scientists and of those promoting women scientists across Europe. Declaration (for ALL applicants) We accept the purpose and aims of the European Platform of Women Scientists AISBL, its key policy statements, joint declarations and rules and procedures as decided by the General Assembly.
Date Signature Position/ Function
Please return completed form to: European Platform of Women Scientists EPWS (c/o Dr Dora GROO) Association of Hungarian Women in Science 1255 Budapest, P.O.B. 206, Hungary E-mail:
[email protected] URL: www.epws.org
Declaration (for the applicants for Full Membership only)
We herewith declare that our association, according to the statutes which we are enclosing, is a legally registered non-governmental non-profit organisation acting independently of any political party or religious authority, and that its aims, goals and interests do not oppose the aims, goals and interests of the European Platform of Women Scientists AISBL.
Date Signature Position/ Function
Please return completed form to: European Platform of Women Scientists EPWS (c/o Dr Dora GROO) Association of Hungarian Women in Science 1255 Budapest, P.O.B. 206, Hungary E-mail:
[email protected] URL: www.epws.org
3 Jan 2013
The European Platform of Women Scientists is a network of networks of women scientists and of those promoting women scientists across Europe.
Terms and Conditions The application for admission as a member of EPWS will be addressed to the Executive Committee by means of written communication. The applicants must specify in their application which type of membership they are applying for. They must also demonstrate their compliance with all the relevant membership criteria. The application must be accompanied by the documents and data requested for each type of membership. The Executive Committee is entitled to ask the applicant any additional information it deems necessary in order to issue its advice to the Board of Administration. If these bodies ask for any such additional information, the application procedure will be suspended until this additional information is communicated by the applicant. The Executive Committee will make recommendations to the Board of Administration concerning all applications for membership. The Board of Administration will vote to accept or reject each membership application on the basis of a simple majority. The applicant, whose application for membership is being accepted, will confirm its acceptance of the Statutes, the Internal Rules and the key policy statements and joint declarations of the Association by returning the Statement of Admission to the Association, completed and duly signed by its legal/official representative. Brussels, November 2006
4 Jan 2013
