1、 創(chuàng)意101國(guó)際孵化器入孵申請(qǐng)表101 Creative Exchange Application Form填表日期Date:_ 編號(hào)No._公司名稱(chēng)Company Name申請(qǐng)人Applicant 手機(jī) Mobile網(wǎng)站website電子郵件Email團(tuán)隊(duì)總?cè)藬?shù) Total Number of Team Members :入駐成員信息 Intended Members Applying for the Space姓名Name國(guó)籍Nationality職務(wù)Position工作經(jīng)驗(yàn)Work Experience教育程度Education企業(yè)基本情況與孵化計(jì)劃 Company Informatio

2、n and Incubation Plan 行業(yè)類(lèi)型Enterprise Category 注冊(cè)時(shí)間Registration Date (if registered)（已注冊(cè)企業(yè)填寫(xiě)）注冊(cè)地址Registration Address (if registered)卡位需求How many desks do you need?_ 個(gè)卡位 desk(s)使用孵化器的頻度How often do you need to use the incubator?公司介紹（可另行附頁(yè)說(shuō)明） Introduction of the company and product / services(an extra

3、 page is allowed to attach):是否擁有發(fā)明專(zhuān)利?If applicable, do you have a patent/ IP for your product / technology/ creation?是Yes_ 否No_若是，請(qǐng)?zhí)峁?zhuān)利詳情 If yes, please provide details of the patent專(zhuān)利名稱(chēng)Name of Patent受理號(hào)Patent Number申請(qǐng)時(shí)間Date of Patent專(zhuān)利簡(jiǎn)述Brief Description在深圳（中國(guó)）未來(lái)一年的工作計(jì)劃（可另行附頁(yè)說(shuō)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):其它需要說(shuō)明的情況（可另行附頁(yè)說(shuō)明） Additional Information (an extra page is allowed to attach)：企業(yè)/團(tuán)隊(duì)保證上述提供的材料真實(shí)、可靠，并承擔(dān)由此引起的相關(guān)責(zé)任。The company/ team mentioned above hereby certifies that the information given here is true and reliable, and assumes all liability arising. 簽名Sign:_ 日期Date:_創(chuàng)意101運(yùn)營(yíng)團(tuán)隊(duì)審核Assessment by 101 Creative Exchanges Operation Team創(chuàng)意101意見(jiàn) Assessment 101 Creative Exchange: 簽名Sign:_ 日期Date:_深圳創(chuàng)意投資集