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| <td align=LEFT valign=TOP colspan="2"><font face="Arial" size="5">To be |
| completed by the new Committer.</font></td> |
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| <td align=LEFT valign=TOP colspan="2" bgcolor="#0080C0"><strong><font color="#FFFFFF" face="Arial,Helvetica">Eclipse Foundation Member Committer Questionnaire</font></strong></td> |
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| <td colspan="2">February 28, 2005 |
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| <br> |
| <strong style="font-weight: 400">This document is to be completed by each individual who is employed by, or is an independent contractor of, an Eclipse Member, is covered under |
| that member's Member Committer Agreement, and is seeking Committer status for an Eclipse project.</strong> |
| <p>If you have any questions, please send an email to the <a href="mailto:emo@eclipse.org"> EMO</a>. </p> |
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| <td colspan="2"><strong>Have you read and agree to abide by the terms of the <a href="http://www.eclipse.org/legal/committerguidelines.html">Eclipse Foundation Committer Guidelines</a>? </strong></td> |
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| <td> </td> |
| <td> </td> |
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| <td align="right">If you agree, please indicate by<br> |
| responding Yes.</td> |
| <td><input type="checkbox" name="hasReadGuidelines" value="YES" /><label for="hasReadGuidelines">Yes</label></td> |
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| <td colspan="2"> </td> |
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| <tr><td colspan="2"><strong>Your Info</strong><br></td></tr> |
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| <td colspan="2">Please provide your contact details:</td> |
| </tr> |
| <tr><td align="right">Name: </td><td width="78%"><input type="text" size="60" name="yourName"></td></tr> |
| <tr><td align="right">Organization: </td><td><input type="text" size="60" name="yourOrganization"></td></tr> |
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| <td align="right">Eclipse Project: </td> |
| <td><input type="text" size="60" name="yourProject"></td> |
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| <tr><td align="right">Address: </td><td><input type="text" size="60" name="yourAddress1"></td></tr> |
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| <td> </td> |
| <td><input type="text" size="60" name="yourAddress2"></td> |
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| <td> </td> |
| <td><input type="text" size="60" name="yourAddress3"></td> |
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| <td align="right">E-mail: </td> |
| <td><input type="text" size="60" name="yourEmail"></td> |
| </tr> |
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| <td align="right">Phone number: </td><td><input type="text" size="40" name="yourPhone"></td></tr> |
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| <td align="right">Fax number: </td> |
| <td><input type="text" size="40" name="yourFax"></td> |
| </tr> |
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| <td align="right">Mobile number: </td> |
| <td><input type="text" size="40" name="yourMobile"></td> |
| </tr> |
| <tr><td> </td></tr> |
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| <td colspan="2"><strong>With regard to your participation as a committer in your project, it is understood that you are participating in this project as part of your regular employment with, or duties as an independent contractor for:</strong></td> |
| </tr> |
| <tr> |
| <td align="right"> Please enter the name of the<br> |
| Eclipse Member company:</td> |
| <td><input type="text" size="60" name="memberCompany"></td> |
| </tr> |
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| <td align="right">Please confirm this understanding<br> |
| by responding “Yes”. </td> |
| <td><input type="checkbox" name="isMemberEmployee" value="YES" /><label for="isMemberEmployee">Yes</label></td> |
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| <tr><td> </td></tr><br> |
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| <input type="hidden" name="state" value="submit" /> |
| <input type="reset" name="Reset" value="Reset"> |
| <input type="submit" name="Submit" value="Submit"> |
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