European Union : Application Form for CRSC CWG

APPLICATION FORM

APPLICATION FORM Consultative Working Group of ESMA's Corporate Reporting Standing Committee

Dear Madam, Sir,

Please find enclosed the application of [name of applicant] in response to the call for expressions of interest (Ref: ESMA/2016/1544) to become a member of the Consultative Working Group (CWG) of ESMA's Corporate Reporting Standing Committee (CRSC).

This application includes the following documents (please underline the relevant answer):

Detailed curriculum vitae (CV) of the person replying to the call for expressions of interest. The detailed CV should specify the different diplomas obtained (copies of which may be requested by ESMA), the expertise and experience relevant to the call forexpressions of interest	YES	NO
The completed application form (including Sections 1 and 2 attached hereto)	YES	NO
Motivation letter	YES	NO

I hereby commit, should I be appointed as a member of the CRSC CWG, not to disclose, share or more generally make public the content, in part or in full, of any non-public papers I may be provided with in my capacity of member of the CRSC CWG.

_________________________________________________

Name (Title / First name / Surname)

_________________________________________________

Date (dd/mm/yyyy)

SECTION 1 - IDENTIFICATION
NAME
CONTACT ADDRESS
CONTACT DETAILS			Telephone:
			E-mail address:
NATIONALITY			Applicant
			Of firm/organisation (if applicable):
CURRENT POSITION HELD
SECTION 2 - CRITERIA
TYPE OF BACKGROUND[1]		Financial reporting
		A minimum of 10 years' relevant professional experience in the financial reporting activities will be required for the accountants and auditors.			YES	NO
		Corporate reporting
		A minimum of 7 years' experience relevant to the corporate reporting field will be required for the stakeholders from the other categories.			YES	NO
		Users of financial information
		A minimum of 7 years relevant experience related to financial and corporate reporting will be required.			YES	NO
		Issuers of securities
		A minimum of 7 years relevant experience related to financial and corporate reporting will be required.			YES	NO
		Accountants and auditors
		A minimum of 10 years relevant experience related to financial and corporate reporting will be required.			YES	NO
		Parties involved in the storage of regulated information and its use
		A minimum of 4 years relevant experience related to financial and corporate reporting will be required.			YES	NO
		Representatives of consumer associations or non-governmental organisations, retail investor associations and academics
		A minimum of 4 years relevant experience related to financial and corporate reporting will be required.			YES	NO

[1]Please indicate your background by underlying, "yes" or "no" under the relevant category. You may indicate more than one background. To do so, please underline "yes" or "no" under the relevant categories and indicate your primary background by checking the box on the right side of your primary category.