Registration



Username:*
(max 15 characters)
Password:*
(min 8 characters)
Confirm Password:*
(min 8 characters)
First Name:*
Last Name:*
E-mail:*
 
 
Institution:*
Institution profile:*
City:*
Region:*
Country:*
Full address
(institution, department, street, postcode, city, country):*
Level of competence and action :*
Legal Status:*
If you choose Other could you please specify your legal statute? :
Personal position within the institution:*
Telephone number:*
Permanent email of the body*
(in case the contact leaves his/her position):
Skype contact:
Twitter account:
 
 
Keywords (5 maximum) to define your institution and/or personal profile*
(Separate your keywords with semicolon):
Type of commitment toward Med Maritime projects:*
Project partner
Associated partner
External expert
End user / beneficiary
Tester in pilot actions/use of product/service
Attendance at informative/promotional events/meetings
Member of community/network
Other
If you choose Other could you please specify your Type of commitment toward Med Maritime projects?:
Involvement in other programmes' projects (ENPI, Interreg IVC, Horizon 2020, ALCOTRA, MARITTIMO,...)
If applicable please precise:
 
 
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Terms and Conditions
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I have read the terms and conditions regarding the use of the data I will provide through this form.

I agree to be registered in the COM&CAP MarInA-Med database and to the sharing of my personal information within the network.
 
I don't Accept      I Accept
 
 
 
* These fields are obligatory.