To register with H2NET, please print this web page and return the completed form by post or fax.

Alternatively, you can download and complete the electronic registration form and return it by e-mail.

This information will be held on computer by the Central Laboratory of the Research Councils 
(CLRC)  which is registered under the Data Protection Acts 1984 and 1998. The information 
will be managed as a membership database by Dr. A.G. Dutton and may be passed to 
other members of the Hydrogen Energy Network. 

[__] :	I agree to the following information being held in the membership database 	

Please print clearly in black ink. Continue on an extra sheet if necessary.

Part I	CONTACT DETAILS:

Title:  ____________________   First Name and Initials: ___________________________

Surname: _______________________________________________________________

Organisation:  ___________________________________________________________

Department:  ____________________________________________________________

Web site URL: ___________________________________________________________

Address:  _______________________________________________________________

_______________________________________________________________________

Postcode: ____________________________  Country: ___________________________

Tel.:  ___________________________________   Fax.:  __________________________

E-mail:  _________________________________________________________________

Part II	BACKGROUND QUESTIONNAIRE :

Organisation activity:		Commercial / Research *

Groups with commercial interests - please fill in section A. 
Groups with research interests - please fill in section B.

A. Commercial organisations

Type of company (e.g. Consultant, Developer, Manufacturer etc.): _____________________

_______________________________________________________________________

Areas of expertise:  ________________________________________________________

_______________________________________________________________________

Please give a brief description of the company's business: __________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

Number of employees:  _____________________________________________________

Status of company:				UK-based only / International *

Do you carry out in-house research?		Yes / No *				

If Yes, on what topics?:  _____________________________________________________

_______________________________________________________________________
B. Researchers

Type of research organisation (e.g. University, Research Institute etc.): _________________

_______________________________________________________________________

Position within organisation (e.g. Head of Department, Lecturer, PhD student etc.): ________

________________________________________________________________________

Areas of expertise/interest: ___________________________________________________

________________________________________________________________________

Please give a brief description of your research activities:  ___________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Have you worked on commercial collaborations before?	Yes / No *

If Yes, give examples:  _______________________________________________________

________________________________________________________________________

________________________________________________________________________

Part III	ADDITIONAL INFORMATION:

Where did you first hear about the Hydrogen Energy Network? _________________________

_________________________________________________________________________

What do you hope to gain from the Network's activities?  ______________________________

_________________________________________________________________________

_________________________________________________________________________

Signature  ______________________________________________   Date  ____________

Please return your completed form to:

DR GEOFF DUTTON
Hydrogen Energy Network Director
Energy Research Unit				Tel.:  +44 (0) 1235 445823
Rutherford Appleton Laboratory			Fax.: +44 (0) 1235 446863
Chilton, Didcot					E-mail: a.g.dutton@rl.ac.uk
Oxfordshire, OX11 0QX, UK

                                                      * delete as appropriate

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