创意101国际孵化器入孵申请表

1、 创意101国际孵化器入孵申请表101 Creative Exchange Application Form填表日期Date:_ 编号No._公司名称Company Name申请人Applicant 手机 Mobile网站website电子邮件Email团队总人数 Total Number of Team Members :入驻成员信息 Intended Members Applying for the Space姓名Name国籍Nationality职务Position工作经验Work Experience教育程度Education企业基本情况与孵化计划 Company Informatio

2、n and Incubation Plan 行业类型Enterprise Category 注册时间Registration Date (if registered)（已注册企业填写）注册地址Registration Address (if registered)卡位需求How many desks do you need?_ 个卡位 desk(s)使用孵化器的频度How often do you need to use the incubator?公司介绍（可另行附页说明） Introduction of the company and product / services(an extra

3、 page is allowed to attach):是否拥有发明专利?If applicable, do you have a patent/ IP for your product / technology/ creation?是Yes_ 否No_若是，请提供专利详情 If yes, please provide details of the patent专利名称Name of Patent受理号Patent Number申请时间Date of Patent专利简述Brief Description在深圳（中国）未来一年的工作计划（可另行附页说明）Your work plan in Sh

4、enzhen/ China and the purpose of using the co-working space for the year ahead (an extra page is allowed to attach):其它需要说明的情况（可另行附页说明） Additional Information (an extra page is allowed to attach)：企业/团队保证上述提供的材料真实、可靠，并承担由此引起的相关责任。The company/ team mentioned above hereby certifies that the information given here is true and reliable, and assumes all liability arising. 签名Sign:_ 日期Date:_创意101运营团队审核Assessment by 101 Creative Exchanges Operation Team创意101意见 Assessment 101 Creative Exchange: 签名Sign:_ 日期Date:_深圳创意投资集