Affiliate Member Registration
Title :
First Name :
Last Name (*) :
Company or Organization :
Name :
Tel :
Fax :
E-mail (*) :
Website :
Address :
Zip Code :
City :
Country :
Organization Type :
Research Organisation
Government institution
Private laboratory
Academic institution
Organisation Activity :
Special research activity :
Interest and achievement in the fields of nano-technology and nano-sciences :
Involvement in a EU project :
No
Yes
Involvement in a EUREKA project :
No
Yes
Membership of a EU Network and/or industrial association :
No
Yes
Proposal for collaboration with MASMICRO Project (*) :
Intended contribution to MASMICRO Project