Dear President of the Board of Fórum Oceano – Associação da Economia do Mar, _______(local)_______, ______ (date) ______ SUBJECT: FORUM OCEANO MEMBERSHIP APPLICATION TO PURCHASE THE QUALITY OF ASSOCIATE. ________(name of the organization)________________, headquartered at ____________________________________________, VAT nº _____________________ registered at the Companies Registry under the number _______________, comes, hereby, request. its admission as an Associate of the private and non-profit association called Fórum Oceano – Associação da Economia do Mar (Association of the Sea Economy), headquartered at Av. da Liberdade, S/N, 4450-718 Leça da Palmeira, in the parish of Leça da Palmeira, Matosinhos municipality, Portugal, with the VAT nº. 509 072 763. (Association Stamp and LEAR signature; please rubric the remaining pages) Attached required to this document: – Informative Data of Applicant Organization 1/3 INFORMATIVE DATA OF APPLICANT ORGANIZATION 1. Contacts: Organization Designation Headquartered at Address for correspondence (if different from headquarter) Phone (general) Fax Website E-mail (general) Organization contact person: Name Position Phone E-mail 2. Other data: VAT number Date of establishment Capital stock Date of the beginning of activity dd-mm-yyyy The following information is related to the year dd-mm-yyyy (year) If the applicant organization is a holding company, the “workstations” fields must considerate the total of employs of the group Number of Delegations Economical main work codes Workstations Workstations in Portugal Economical secondary work codes Size (turnover) Gross Added Value (GAV) Main Products / Services offered Main destiny markets (please specify) 2/3 3. Theme(s) of interest for your organization (please, indicate with X): Environment Aquaculture Marine Biotechnology and Bio Resources Fish Conservation, Processing and Marketing Shipbuilding, Maintenance and Ship Repair Boat and Yatch Building, Maintenance and Repair Maritime Defence and Security Research and Technological Development Nautical Maritime construction Offshore and Oil&Gas Fishery Ports, Transport and Logistics Marine Minerals Resources Marine Renewable Energy Education and Training, Basic or Professional Higher Education and Training Services Technology Information, Communication and Electronics (TICE) Marine Technologies Equipment and Infrastructures Tourism Other 4. Please specify: i. The expected contribution of the Cluster to the development of your Organization: ii. The potential contribution which the Organization can provide for the development of the Cluster 3/3