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A. Your name and address
Name
Family name
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Mr.
Ms.
Dr.
Prof.
E-mail address
B. Your affiliation
Organisation (full name)
Organisation short name / initials
Country (select one from the list)
Europe
Albania
Andorra
Armenia
Austria
Azerbaijan
Belarus
Belgium
Bosnia and Herzegovina
Bulgaria
Croatia
Cyprus
Czech Republic
Denmark
Estonia
Finland
France
Georgia
Germany
Greece
Hungary
Iceland
Ireland
Italy
Latvia
Liechtenstein
Lithuania
Luxembourg
Macedonia
Malta
Moldova
Monaco
Netherlands
Norway
Poland
Portugal
Romania
San Marino
Serbia and Montenegro (Yugoslavia)
Slovakia
Slovenia
Spain
Sweden
Switzerland
Ukraine
United Kingdom
Vatican City
Outside Europe
Algeria
Argentina
Australia
Bolivia
Brazil
Canada
Chile
China
Colombia
Costa Rica
Cuba
Ecuador
Egypt
El Salvador
Guatemala
Guyana
India
Indonesia
Iran
Iraq
Israel
Japan
Jordan
Kazakhstan
Korea (north)
Korea (south)
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Mexico
Mongolia
Morocco
Nepal
New Zealand
Nicaragua
Nigeria
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Qatar
Russian Federation
Saudi Arabia
Singapore
South Africa
Sri Lanka
Suriname
Syria
Taiwan
Tajikistan
Thailand
Tunisia
Turkey
Turkmenistan
United Arab Emirates
United States
Uruguay
Uzbekistan
Venezuela
Vietnam
Yemen
Other countries, not listed (indicate)
Main activity of your organisation (select one)
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Research
Education
Industry
Financing
Professional association / society
Other
C. Your interest
Your main activity is mainly related to (select one)
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Research
Education
Industry
Other
Your background is closer to (select one field)
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Basic sciences (except life sciences)
Life sciences
Engineering - Info Soc Technologies
Engineering (other)
Life technologies (biotechnologies)
Economic, social, law and other
Maximum interest for future cooperation with other organisations working in ( one choice)
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Research
Education
Industry