Application Form /Call for Participation

EEP AWARD 2010

Contact information

Company:______

Contact person:______

Position/Title: ______

Address:______

City:______

Country:______

Phone and Fax number:______

Email:______

Webaddress:______

Where the information on the innovation can be found in english

This application form was mailed to:______(e-mail address) /

Send by post to ______(magazine) on ______(date)

Innovation

Name of innovation:

Short description of the innovation and its benefit, in maximum 100 words: Please give a clear description of the technology in not too technical english.

I. Innovation & Progress

Is your innovation a new technology or a transfer of technology?

If it is an already existing technology, give details: name / company. What is the progress of your innovation compared to this existing technology? Please give a clear comparison.

How long did your company work on it?

When was it put on the market? (After 1st January 2008)

What is the break-through of your innovation?

Please, describe precisely what impact your innovation could have on the environment?

And, what is the benefit compared to already existing technologies?

What benefits will your innovation bring to the environment?

(Please, don’t tick the boxes but, shade in greys each of your answers: example, Noisereduction)

 Waste reduction Less water pollution

 Less resources consumption Less air pollution

 Energy saving Noise reduction

 Less emission of greenhouse gases Other:………………………

…………………………………

  1. Environmental Problem and European Influence

How important is the environmental problem your innovation can solve?

Which is the European influence of your innovation and why?

Which European countries could be interested in the use your innovation?

(Please, don’t tick the boxes but, shade in greys each of your answers: example, Belgium)

Albania / Greece /  Portugal
Austria / Hungary /  Romania
 Belarus / Iceland /  Russia
Belgium / Ireland /  Serbia
Bosnia & Herzegovina / Italy /  Slovakia
Bulgaria /  Lativia /  Slovenia
Croatia /  Lithuania /  Spain
Czech Republic /  Luxemburg /  Sweden
Denmark /  Macedonia /  Switzerland
Estonia / Malta /  Turkey
Finland /  Montenegro /  Ukraine
France / The Netherlands /  United Kingdom
Germany /  Norway
  1. Costs and Liability

How much would it cost to purchase your product / process / innovation?

Give us an estimation of the operating and technical maintenance costs of your innovation.

What would be the value-price ratio of such a purchase?

What economical or financial profits, could a company or any purchaser make from your product / process / innovation?

Could you quote existing references, which would prove that your product is already on the market?

Which firm or country is already trying out your innovation?

What are the results?

IV.Statistics

How old is your company?

(Please, don’t tick the boxes but, shade in greys each of your answers: example, 5-10 years)

 Less than 2 years

2 - 5 years

5 - 10 years

more than 10 years

 What is the turnover of your company? (including your plants, branches, divisions and subsidiaries, all over Europe):

(Please, don’t tick the boxes but, shade in grey each of your answers: example, Less than €250,000)

Less than €250,000

€250,000 - € 1 million

€ 1 million - € 10 million

€10 million - € 100 million

€ 100 million - € 1 billion

over € 1 billion

 Is your company located in any other European country? If so, which one(s)?

(Please, don’t tick the boxes but, shade in greys each of your answers: example, Portugal)

Albania / Greece /  Portugal
Austria / Hungary /  Romania
 Belarus / Iceland /  Russia
Belgium / Ireland /  Serbia
Bosnia & Herzegovina / Italy /  Slovakia
Bulgaria /  Lativia /  Slovenia
Croatia /  Lithuania /  Spain
Czech Republic /  Luxemburg /  Sweden
Denmark /  Macedonia /  Switzerland
Estonia / Malta /  Turkey
Finland /  Montenegro /  Ukraine
France / The Netherlands /  United Kingdom
Germany /  Norway

Deadline the fully completed application form should be at the local magazine/EEP:

23 April 2010

(please note: deadlines may differ locally, contact your local member for the exact deadline)

The EEP reserves the right to expel participants from the Award 2010, should they provide wrongful and/or misleading information. The Jury’s deliberations will of course remain confidential.

The EEP may want to use the information provided on this application form, for informative purposes about the Award and the innovations. Should you not approve, please, shade the box in grey: ¨

For more information:

European Environmental Press

– EEP Award 2010 –