Form of pre-subscription to the Biofuels Platform

Form

The fields shown with a star (*) must be completed in order to validate the record.

Contact person

	Last name
	First name
	Phone
*	E-mail

Information regarding your company

*	Company name
	Activity sector
	Address
	Postcode
	Town
	Internet address

Information regarding your vehicle fleet

Does your company have its own vehicle fleet?

YES

Does your company have its own fuel storage/distribution facilities?

YES

	Number of vehicles within your fleet
	- Gasoline
	- Diesel
	- Others

Information regarding biofuels

Are you already using biofuels at present (bioethanol, biodiesel, biogaz)?

YES

Are you aware of the possibilities of using biofuels?

YES

Are your considering to use biofuels in the short-to-medium term?

YES

Are you considering to increase the share of biofuels in the short-to-medium term?

YES

Additional information / Comments

Please, include below any additional information, as well as your comments on this questionnaire and/or expectations of your company. Upon submission of your answers, the message will be sent by e-mail to the Biofuels Platform team.

	Message
	Please, check the box in case you wish to receive a copy of your message.

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Verification

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Date : Saturday 4 February (week 05)
Time : 19:50 GMT +0100
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