Meters and More AIBSL

Rue de la Science 14 b

1040 Brussels

Belgium

Register of Legal Entities Brussels

Enterprise number 0824.390.132

(the "Association")

APPLICATION FORM FOR MEMBERSHIP

Please complete all sections of this application form and sign and return it to the attention of the Chairman of the Board of Directors of the Association at the registered office of the Association (Rue de la Science 14b, 1040 Brussels, Belgium) and by e-mail to the following e-mail address: . The board of directors may request additional information to assess an application. The admission as a Full or Associated Member to the Association requires a decision of the Board of Directors, which shall be taken at the first meeting following the application for membership. Admission shall only become effective after execution of the Accession Agreement and payment of the annual membership fee. The candidate will be kept informed of the following steps in the procedure after submission of this application form.

The Undersigned:

Name of the entity:
Date of its constitution:
Nature of the entity[1]:
Main activities of the entity[2]:
Registered office of the entity:
Registration place and number of the entity (e.g. trade register number and VAT number):
Main reason(s) to join the Association (please also specify whether these are related to the main activities of your company/organization or to new initiatives foreseen within your company/organization):
Please indicate how you have been informed on the existence of the Association (meetings, website, other media etc.):
Name of the contact person, telephone number, fax number and e-mail address for matters in relation to the Association[3]:
Name of the person who will represent the entity in the General Meeting of the Association:
Name of the contact person, telephone number, fax number and e-mail address for financial matters in relation to the Association (such as e.g. the invoicing of fees):

Hereby declares to have read the Articles of Association of Meters and More AISBL, to apply for admission as, and undertakes to pay the annual membership fee for this year as indicated below[4][5]:

A. Full Member

○ Category 1 Full Member: EUR 45.000

○ Category 2 Full Member: EUR 30.000

○ Category 3 Full Member: EUR 15.000

B. Associated Member

○ for non-profit entities, governmental organisations and educational institutions in general : EUR 1.000

○ for purely R&D focused non-profit entities provided that they assure an active participation in at least one of the committees/working groups contemplated in art. 33 of the Articles of Association[6] : 100 EUR

○for other entities: EUR 2.000

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B. Associated Member, for other entities.

For the Undersigned,

______

Place and date

Name: Name:
Capacity: Capacity:

If you would have any questions regarding this application form or you would like to receive a copy of the Articles of Association of Meters and More AISBL, please contact the secretariat by e-mail at.

1

[1]Profit or non-profit entity, governmental organisation or educational institution.

[2]The main activities of the entity and, in case of a profit entity, also the relevant industry sector.

[3]E.g. for sending the convocation letter for the General Meeting.

[4] Please mark your choice.

[5] Please note that a Category 1 Full Member has three votes, a Category 2 Full Member has two votes and a Category 3 Full member has one vote in the General Meeting. As for the powers of the General Meeting related to the creation and decisions regarding the working groups (“committees”), as set forth in Article 15, each Full Member shall be entitled to 1 vote. Associated Members have the right to attend the General Meeting and participate in discussion but have no voting rights in the General Meeting.

[6]for the sake of clarity, they cannot be absent for three (3) consecutive meetings of the said committees/working groups without due justification; being agreed that, the non-fulfilment of such undertaking shall automatically terminate their membership. Terminated members can still apply as regular Associated Members or Full Members.