“GLOBE Verified: Your trusted mark of assurance for technology performance” * = Required FieldAbout You and Your CompanyCompany Name*Contact Person* First Last Job Title*Address* Street Address City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Email* Phone*Please identify any staff and associates of GLOBE Performance Solutions with whom you have discussed the preparation of this application:General Description of the TechnologyTechnology NameBriefly describe your environmental technology. You are encouraged to include technical literature and/or promotional material describing the technology:Performance ClaimBriefly-describe the technology performance claim(s) that you want to be verified. Note that the claim(s) you provide here are considered draft and may be altered after discussion with GLOBE Performance Solutions and / or a verification expert.Technology / DataThe technology*is now commercially availableis expected to be available by (enter date below)Date technology is expected to be available.If applicable, please select a date The applicant has test data (before & after technology installation/operation) which supports the performance claim.*Yes / TrueNo / Not TrueIf "Yes", please indicate which organization conducted the test.When was the testing conducted? The applicant wishes to discuss an appropriate test program*YesNoOwnership Of The TechnologyOur company possesses full ownership of the technologyOur company is a licensed distributor of the technologyConflict Of InterestIn order to ensure that verification activities are completely impartial, any actual or perceived conflict of interest with GLOBE Performance Solutions, including its employees and agents, must be identified and resolved prior to review of a Formal Application. Please identify any actual or perceived conflict of interest.*Supporting DocumentsFileAccepted file types: pdf, docx, jpg, gif, png, xlsx, pptx.FileAccepted file types: pdf, docx, jpg, gif, png, xlsx, pptx.FileAccepted file types: pdf, docx, jpg, gif, png, xlsx, pptx.FileAccepted file types: pdf, docx, jpg, gif, png, xlsx, pptx. This iframe contains the logic required to handle Ajax powered Gravity Forms. Share this page with your network!