ECOPOWER Application

Membership Application

Submitting of online Application for membership within the Association is the first step in obtaining of membership. Perspective Applicants are requested to read carefully Rules & Regulations, Code of Conduct, Web Terms & Conditions, Web Communications Policies and Due Diligence Policy before filling and submitting the present online Application.
Please be aware that directors of the Association are deciding concerning approval or rejection of the present Application, and that perspective applicants will be informed via e-mail about taken decision. All fields marked with "*" are mandatory to be filled with proper information, since it is vital in reviewing and deciding concerning approval or rejection of the present online Application.
Application requires uploading of electronic documents-scanned copies of Passport, utility bills (not older than three months) and corporate documents-please upload them in PDF or any picture format.
Applications must be filled and submitted by individual person, since membership cannot be granted without determination of ultimate beneficial ownership in the case that corporate membership is requested-see section "Corporate Membership" of the present online Application.
All information received are confidential and will be treated as confidential. Personal information will not be shared or forwarded to third parities without prior consent given by the applicant.

* Indicates required field

Applicant Identification
This application must be filled and submitted by physical person-if you apply on behalf of company related to you, you can obtain corporate membership, but the Association will treat you as beneficial owner of introduced company for appropriate type of membership in the case that membership is granted.

Name *

First

Last

Previously held names (if any) *

First

Last

Passport *

Place & Date of Issuing *

Valid Until *

Citizenship *

Please Upload Scanned Passport *

Max file size: 20MB

Contact Details
Hereby provided details will be used in future communications, unless their change will be advised by the member.

Residential Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Mobiile Phone *

Email *

Other Contacts

SKYPE Name *

Facebook *

Know Your Client Details
Source of Income, Proof of Residential Address & Due Diligence Record
The continuing threat of money laundering is most effectively managed by understanding and addressing the potential money laundering risk, associated with customers and their transactions (”Know Your Clients”-KYC). Based on Wolfsberg AML Principles, Association ECOPOWER and its corporate directors have implemented KYC Policy to assist members, its clients, associates and administrators to manage money laundering risk. Information hereby requested is fully in accordance with Due Diligence Policy of the Association, and will be treated as confidential.

Employment Information

Current Place of Work/Company's Name *

Company's Website *

Company's Phone Number *

Due Diligence Record

Have you ever been involved in a legal violation/breach in any jurisdiction? *

Yes No

Have you ever been under a tax investigation of the authorities in any country? *

Yes No

Address of the Company *

Line 1

Line 2

City

State

Zip Code

Country

Employment Position *

Are you (or members of your family) politically exposed in any country? *

Yes No

Have you ever been a bankrupt or an employee of the company that went bankrupt in any jurisdiction of the world? *

Yes No

If you answer "Yes" on any of questions above, please provide detailed info here: *

Corporate Membership
In the case that your intention is to obtain corporate membership for related company to you, please provide us with all details provided bellow, since they are vital for reviewing of the present online Application. If you are not ultimate beneficial owner of the Company hereby introduced, please be aware that professional membership cannot be granted without given consent from ultimate beneficial owner-without such consent, provided that all other requirements are matched, professional membership might be granted personally to the Applicant, and he will be treated as beneficial owner of entities delivered to him in the course of membership's benefits.

Contact Details
In the case that corporate membership will be granted, hereby provided details will be used in official communications.

Business Address *

Line 1

Line 2

City

State

Zip Code

Country

Office Email *

Office Phone Number *

Official Website *

Facebook *

Twitter *

SKYPE *

VIBER *

Officers & Servants

Director's Full Name *

Name of the Prime Bank *

Lawyer/Legal Representatives *

Accountant *

Secretary (if any) *

Bank's Website *

Lawyer's Website *

Accountant's Website *

Undertaken Businesses

Business Description *

Main Products/Services *

Indemnity Insurance Coverage *

Yes No

Covered by *

Audited Financial Statements *

Yes No

Audited by *

Applicant's Confirmation

Acceptance of Rules and Regulations *

Accepted Not Accepted

Participation Subscription Payment *

Affiliate Package [1,000 E] Professional Package [10,000 E] Sponsorship [30,000 E] Other Amount

Other Amount [if it is not selected above] *

I confirm that provided information in the present online Application are true, correct and lawful, and I fully understood and accept terms and conditions of membership within Association ECOPOWER described in Memorandum and Articles of Association, Code of Conduct, Web Terms & Conditions, Web Communication Policies.as well as Due Diligence Policy, published at this website, as well as, that I haven’t received any financial or tax advice from Association ECOPOWER, its directors and employees concerning my decision to contribute through submitting the present online Application and payment participation subscription in the course of the present online Application.
Submitting of the present online Application is expression of my free will and my sole decision made under clear understandings of all aspects related to desired membership.

I undertake to pay selected participation subscription in accordance with instructions that Association ECOPOWER shall send me in the course of reviewing of the present online Application. I'm aware that selected amount of Participation Subscriptions will be invoiced by the corporate director, and that an invoice will be sent in electronic form upon received application, with detailed payment instruction.

In the case of payment via banking wire transfer, I understand that I have to cover relevant bank charges in order to secure that net Participation Subscription will be received.
In the case of online payments, I understand and agree that my payment card will be debited for amount of selected Participation Subscription, and that I'm not responsible for any charges related to processing of approved online payment.

Affiliate Introduction *

Yes No

If answer is "Yes" please provide Affiliate's Membership Certificate Number *

Submit