NextFlex Membership - Part 1

A “Foreign Entity” means an organization, institution or person that is not a U.S. Entity, where “U.S. Entity” means an organization, institution or person that: (i) one or more U.S. persons own directly or indirectly stock entitling such persons to fifty percent (50%) or more of the votes at a meeting of the shareholders, (ii) if voting stock has not been issued, then one or more U.S. persons own directly or indirectly ownership interests that together represent ownership of fifty percent (50%) or more; (iii) stock in the entity is publicly-traded on a recognized United States exchange and the entity has substantial research, development and/or manufacturing operations within the U.S.; (iv) is a United States based college or university; or (v) is a United States citizen.

Full Legal Name:*

Other names known by (e.g., “dba”, trade name):*

Entity status (e.g., for-profit corporation, not-for-profit research institution): *

Country of incorporation/formation:*

Principal Address*

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Country

Country(ies) in which Applicant maintains a physical presence (e.g., office, research or production facility): *

Industry sector(s) (e.g., aeronautics, medical devices, consumer products):*

Primary operation(s): (e.g., R&D, engineering services, materials supplier, manufacturer, end-product brand):*

Total number of employees:*

Number of employees located in the U.S.:*

1.Describe Applicant’s operations within the Unites States, particularly with respect to flexible hybrid electronics (e.g., employees, facilities, customers, collaborators, other investments in flexible hybrid electronics R&D or manufacturing, or engagement with the U.S. Government):

a. Current: *

b. Anticipated: *

2. Describe the anticipated benefits to NextFlex, U.S. industry and U.S. economic development from Applicant’s participation in NextFlex activities or project teams, inclusive of any anticipated advancements of U.S. manufacturing or education and any knowledge or resources not otherwise available in the United States?*

3. Describe Applicant’s motivation to participate in NextFlex. Applicant’s response to this question is only for the purpose of aiding evaluation of this Questionnaire and will form no part of any Participation Agreement into which Applicant may enter, despite this Questionnaire’s general incorporation into such Participation Agreement. *

4. Describe Applicant’s plan, including IP and data protection protocols for any international transfer of data and information within Applicant’s organization (e.g., between a U.S. subsidiary and its foreign parent organization), to ensure Applicant’s compliance with applicable export control laws and regulations, applicable privacy laws and regulations, and customary confidentiality and cybersecurity provisions. *

5. Describe measures that Applicant will take towards avoiding intellectual property infringement upon U.S.-owned companies or organizations due to Applicant’s participation in NextFlex (e.g., whether Applicant conducts relevant patent searches, implements internal need-to-know controls, other measures).*

6. Confirm that Applicant will conduct any NextFlex project work solely within the U.S. and will not spend any NextFlex funds outside of the U.S. (except as expressly approved by NextFlex).*

7. Does any non-U.S. government have an interest in, association with, or provide funding for Applicant? If so, please describe.*

8. Identify by name and country(ies) of incorporation and operation any Affiliate(s) with whom Applicant desires to share or disclose information or benefits Applicant may receive from its participation in NextFlex, where “Affiliate” means any individual, corporation, partnership or other entity that controls, is controlled by or is under common control with Applicant, with “control” meaning directly or indirectly owning a majority equity interest in, or otherwise having the power to direct the business affairs of, the controlled entity (e.g., electing a majority of a board of directors or its equivalent, or appointing or removing its management). If available, please provide an organizational chart of Applicant’s relationship to such Affiliate(s).*

9. Confirm Applicant’s compliance with U.S. employment law, including but not limited to 8 U.S.C. 1324a (Unlawful employment of aliens) and 8 CFR 274a.2 (Verification of identity and employment authorization), with respect to Applicant’s personnel to whom U.S. employment law is applicable.*

10. Confirm, if Applicant were to be approved for participation in NextFlex, that Applicant agrees to be subject, with respect to Applicant’s participation in NextFlex, to the state and federal laws of California and the United States of America, without regard to the body of law controlling conflicts of law, and that Applicant by virtue of executing a NextFlex Participation Agreement thereby consents to exclusive jurisdiction and venue of the state and federal courts located in Santa Clara County, California with respect to related matters unless all parties to the particular matter otherwise agree in writing to an alternative jurisdiction and/or venue. *

By signing this Questionnaire, Applicant attests that the information provided is accurate and not misleading as of the date below (“Submission Date”), and NextFlex may rely on such information. Applicant understands this Questionnaire will be provided to NextFlex’s Governing Council and the U.S. Government Program Manager for evaluation, and that if Applicant is approved to participate in NextFlex, this Questionnaire will be incorporated by reference into Applicant’s Participation Agreement.

Name

First Name

Last Name

Signature

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If you are a start-up company meeting the definition on our Membership page, you have the option to be an Observer or a full member (Tier 1, 2, or 3). Please refer to our website for additional details (https://www.nextflex.us/membership-inquiry-form/).

Application for NextFlex Participation Foreign Entity Questionnaire