Your Name* Your Organization and Region Your Email* Your Phone Number Note: For subsections a, b, c, d, e of each question, you can just answer the ones that are applicable to you and leave the rest blank. 1. How important is the following issues in your organization? a. Cost Reduction and Revenue Generation 0-10 scale; 0 = not important at all, 10 = utmost importance Please briefly explain. b. Environment and Energy 0-10 scale; 0 = not important at all, 10 = utmost importance Please briefly explain. c. Easy implementation and scale 0-10 scale; 0 = not important at all, 10 = utmost importance Please briefly explain. d. Regulatory Requirements 0-10 scale; 0 = not important at all, 10 = utmost importance Please briefly explain. e. Public Images and Others 0-10 scale; 0 = not important at all, 10 = utmost importance Please briefly explain. 2. What is your reaction to each of the following elements of elerGreen multipurpose electrochemical production technology? a. Polymer 0-10 scale; 0 = not interested/important at all, 10 = utmost interest/importance Please briefly state, all positive and/or negative comments that come to mind. b. Chemicals 0-10 scale; 0 = not interested/important at all, 10 = utmost interest/importance Please briefly state, all positive and/or negative comments that come to mind. c. Waste Management 0-10 scale; 0 = not interested/important at all, 10 = utmost interest/importance Please briefly state, all positive and/or negative comments that come to mind. d. Reactor Device 0-10 scale; 0 = not interested/important at all, 10 = utmost interest/importance. Please briefly state, all positive and/or negative comments that come to mind. e. Overall and Others 0-10 scale; 0 = not interested/important at all, 10 = utmost interest/importance Please briefly state, all positive and/or negative comments that come to mind. 3. In your opinion, which specific processes or end-use applications (in your organization or elsewhere) would be most likely to adopt the technology? Please briefly explain for each. a. Polymer b. Chemicals c. Waste Management d. Reactor Device e. Overall and Others 4. In your opinion, what would the major market or technical challenges/barriers to entry be for elerGreen multipurpose electrochemical production technology? a. Polymer b. Chemicals c. Waste Management d. Reactor Device e. Overall and Others 5. In your opinion, is there any substitute or alternative product that could pose a threat to elerGreen multipurpose electrochemical production technology? Please briefly explain. a. Polymer b. Chemicals c. Waste Management d. Reactor Device e. Overall and Others 6. How significant an economic advantage would it require for you to consider using the products, or adopting the process in-house, for the elerGreen multipurpose electrochemical production technology? (thinking in terms of cost reduction percentage, payback period, or other unit of measure) a. Polymer 0-10 scale; 0 = not significant at all, 10 = utmost significance Please briefly explain. b. Chemicals 0-10 scale; 0 = not significant at all, 10 = utmost significance Please briefly explain. c. Waste Management 0-10 scale; 0 = not significant at all, 10 = utmost significance Please briefly explain. d. Reactor Device 0-10 scale; 0 = not significant at all, 10 = utmost significance Please briefly explain. e. Overall and Others 0-10 scale; 0 = not significant at all, 10 = utmost significance Please briefly explain. 7. At what price point and product volume would the materials need to be of interest for your company? Please write as many that comes to mind. a. Polymer Item and Price (In terms of Unit and Currency) b. Chemicals Item and Price (In terms of Unit and Currency) c. Waste Management Item and Price (In terms of Unit and Currency) d. Reactor Device Item and Price (In terms of Unit and Currency) e. Overall and Others Item and Price (In terms of Unit and Currency) 8. Other than economics, would there be any other major reason to consider adopting a product or a system like elerGreen multipurpose electrochemical production technology? Please briefly explain for each as applicable. a. Polymer b. Chemicals c. Waste Management d. Reactor Device e. Overall and Others 9. What purity or any other specification, of materials would be needed for your organization? Please add any comment as applicable. a. Polymer b. Chemicals c. Waste Management d. Reactor Device e. Overall and Others 10. Would you be interested in discussing this technology opportunity, or outside or collaborative product development with elerGreen directly in the future? YesNoMaybe Please briefly explain. 11. Please name anyone you know (in your organization or outside of it) that you think we should also speak with about this technology (list as many as applicable). Name, Title, Contact and Comment 12. By submission of this form, you agree that you have read and understood the Pre-Order Terms and the Pre-Order Explanation. You further agree, by checking the boxes below, that: You would like to enter into the Pre-Order to line up for the products and pre-order discount at NO COST, cancellable anytime without costYou would like to opt out of the Pre-Order where you would waive your pre-order line-up and discount Date: A copy of Pre-Order Agreement would be sent to your provided email for your record. Do you have any message, or any attachment for elerGreen? Any comment as applicable. Any (Up to 3) attachment to show as applicable. By submitting this form, you agree that you have read, understood and agreed to the Privacy Policy of elerGreen regarding the collection and use of your data and information. You may take your time reading it in details before deciding whether to submit this form. Press "Submit" and you may be contacted at your provided information for potential cash payment. Δ Thank you for your feedback! Pages: 1 2 3
