RTD Partners
Entry Service


Partners Entry Form

Please read Entry Form Instructions before filling out the Entry Form. It is recommended that you use an up-to-date browser (Netscape 1.2 is the minimum requirement). Note that both UPPER and lower case characters should be used. Also, read the instructions concerning the use of the %L which is used to retain a 'new line' in the 'textbox' fields.

Please note that this form (120 Kbytes) may take some time to download.

Section 1 : Organization Details

1.1 Legal Name (mandatory, max. 240 characters)

1.2 Organization Acronym (max. 40 characters)

1.3 Organization Department (max. 240 characters)

1.4 Organization Sub-department (max. 240 characters)

1.5 Address (max. 210 characters, use %L for a new line)

1.6 PO Box (max. 20 characters)
1.7 Post Code (max. 10 characters)
1.8 City (mandatory, max. 40 characters)
1.9 Country (mandatory)

1.10 Parent Organization (max. 240 characters)

1.11 Parent Country (mandatory if you filled out previous field)
1.12 Organization type (mandatory, check one or more of the boxes below. If necessary, use the field Other)
Consultancy Research Education Industry Non Commercial Technology Transfer
1.13 Other Type
1.14 Organization Size
less than 50 50-500 above 500
1.15 Subject sector classification of the organization (mandatory, Please select one to five items)

1.16 Turnover for previous year in national currency (in millions)
.
1.17 Currency
1.18 Description of Activities (Give a concise explanation of the specialization of your organization - but not your department. Max. 2000 characters, use %L for a new line.)

Please Indicate up to 5 European Commission EUREKA, or COST Programmes your organization is/has been involved in.
Involvement 1
1.19.1 Programme 1.19.2 Reference
1.19.3 Title (max. 240 characters)

Involvement 2
1.20.1 Programme 1.20.2 Reference
1.20.3 Title (max. 240 characters)

Involvement 3
1.21.1 Programme 1.21.2 Reference
1.21.3 Title (max. 240 characters)

Involvement 4
1.22.1 Programme 1.22.2 Reference
1.22.3 Title (max. 240 characters)

Involvement 5
1.23.1 Programme 1.23.2 Reference
1.23.3 Title (max. 240 characters)

Section 2 : Contact Person Details

Please ensure that all details are accurate , as people will use this information for the first approach

Name of the Contact Person
2.1 Family Name (mandatory, max. 50 characters)
2.2 First Name (max. 50 characters)
2.3 Initials (max. 15 characters)
2.4 Title (Mr,Mrs,Dr,Professor, max. 25 characters))
2.5 Position in Organization (max. 60 characters)
2.6 Telephone (mandatory, format +CC-AA-LL eg +49-69-798765 for a number in Germany, Frankfurt, max. 40 characters)

2.7 Telefax (max. 40 characters)
2.8 E-mail address (max. 50 characters)
Please fill in the following fields only if the contact persons organization/address is not the same is in Section 1. Note that if you decide to fill one of the following fields you have to fill all the address information, even if parts of it matches the information from Section 1.

2.9 Organization (max. 240 characters)

2.10 Organization Acronym (max. 40 characters)

2.11 Department (max. 240 characters)

2.12 Organization Sub-department (max. 240 characters)

2.13 Address (max. 210 characters, use %L for a new line)

2.14 PO Box (max. 20 characters)
2.15 Post Code (max. 10 characters)
2.16 City (max. 40 characters)
2.17 Country

Section 3: Collaboration Details

A - Profile of collaboration required

3.A.1 Collaboration sought (mandatory, please tick more than one box if necessary)
Participation in call for proposal/tender Further research and/or development support Joint venture agreement Licence agreement Marketing agreemant Manufacturing agreement Financial assistance e.g. venture capital

3.A.2 Collaboration Programme If applicable, please select the European Commission or other programme for which collaboration is sought.

3.A.3 Collaboration Title (Max. 240 characters)

3.A.4 Collaboration Type Details
Please describe further the collaboration sought. If you wish to participate in a call for proposal or tender, please include descriptions of project interests themes (Max. 2000 characters, use %L for a new line.)

3.A.5 Areas of fundamental research interest for the collaboration (mandatory, please select up to 5 items)

3.A.6 Areas of commercial exploitation for the collaboration sought (mandatory, please select up to 5 items)

3.A.7 Progress level of the research for which collaboration is sought (please tick one or more boxes and/or use the other field if appropriate)
Pre-proposal Proposal Preliminary design/feasibility study Intermediate design/research phase Development phase Available for testing/assessment Tested, available for demonstration
3.A.8 Other

B - Profile of partner required

3.B.1 Target partner expertise sought (max. 2000 characters, use %L for a new line.)

3.B.2 Target partner organization type (mandatory, check one or more of the boxes below, and if necessary, use the field Other)
Consultancy Research Education Industry Non Commercial Technology Transfer
3.B.3 Other
3.B.4 Target Partner Region(s) (defaults to Any)
3.B.5 Target Partner Country (mandatory)

Partners already acquired for this collaboration (if appropriate)

Partner 1
3.B.6.1 Partner Name (max. 80 characters)

3.B.6.2 Country
Partner 2
3.B.7.1 Partner Name (max. 80 characters)

3.B.7.2 Country
Partner 3
3.B.8.1 Partner Name (max. 80 characters)

3.B.8.2 Country
Partner 4
3.B.9.1 Partner Name (max. 80 characters)

3.B.9.2 Country
Partner 5
3.B.10.1 Partner Name (max. 80 characters)

3.B.10.2 Country

Partner 6
3.B.11.1 Partner Name (max. 80 characters)

3.B.11.2 Country

C - Declaration of agreement: I confirm that I am entitled to release the information provided on this form. I understand it will be stored electronically and be made accessible to interested parties through CORDIS via databases, directories or CD-ROM.

(If you choose the option to "Submit form" - please wait for confirmation of the acceptance of your form ... otherwise your data may be lost!)

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Date 17:35:4 UT on 10/23/96.