Ecsite membership application form

Ecsite membership application

Thank you for your interest in becoming a member of the Ecsite community, we are looking forward to receiving your application.
Name of your organisation*
Type of structure*

Science centre / science museumNatural history museumResearch body / universityPrivate company / consultancyFestival / science events & performancesProfessional networkOther
Description of your organisation*
Website*
Social media handles
Your invoicing information
Name of legal structure*
Legal status*

Non profitFor profit
Yearly turnover*

< €1 million€1 million - €4,999,999€5 million - €14,999,999€15 million and over
This information will stay confidential. Please take into account your latest known turnover. The annual turnover (or operating income) includes all incomes such as: revenues from admission, educational activities, rental of premises, revenue from rented outreach/ travelling activities and exhibitions, membership dues, financial support from national and local government, grants and funding, restricted funds released during the year, donations, sponsorships (cash only), proceeds from fundraising activities and financial investments such as stock shares in companies. Note that in cases where a member is part of a larger organisation (research institute, university etc.) the declared turnover should consider only the activities related to the science engagement part of the organisation.
VAT number (please write N/A if not applicable)*
Country*
Name - Invoicing contact*

First NameLast Name
Email - Invoicing contact*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Main contact for your organisation

This contact will be Ecsite's main interlocutor and the contact displayed to other Ecsite members on our website
Name - Main contact*

First NameLast Name
Job title - Main contact*
Email - Main contact*
example@example.com
Director/CEO contact
Name - Director*

First NameLast Name
Job title - Director*
Email - Director*
example@example.com
Your activities and values
Please describe the different types of science engagement activities you run. If you’re part of a larger organisation (e.g. university, research institute), please outline the role of science engagement within your organisation’s overall mission and activities.*
How do you connect people to science and technology?*
How do you provide your audiences with free-choice and experiential learning(s)?*
What are your expectations from joining our network?*
Ecsite's position on biodiversity

Ecsite's position on science & evolution

Ecsite's declaration on public engagement in climate change
Should be Empty:

Ecsite membership application

Your invoicing information

Main contact for your organisation

Director/CEO contact

Your activities and values