CONffIDENCE Stakeholders Registration Form

 

Your contact information will only be used for dissemination of the CONffIDENCE project, we will not make this information available to others outside the project.

With your permission, we would however like to list your institution (not your name or contact information) on our website. If you do not wish to have your organization listed as a stakeholder on our site, please indicate this below.

 

Stakeholder information:

 

* required information

    Professional data

    ex: 'Paul'

    ex: 'de Jong'

    ex: 'http://www.MyWebsite.com'

    ex: 'PARIS'

    ex: '0900-858548'

    Your email address will not be used for commercial purposes

    Environmental pollutants
    Pesticides
    Natural toxins
    Heavy metals
    Veterinary drugs









    I do NOT wish my organization name to be listed as a stakeholder on the CONffIDENCE website