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Researcher

 

Title:

title Doctor

title Professor

 

First Name:

f_name

Last Name:

l_name

Passport or ID:

passport

Nationality:

nationality

Academic Grade:

a_grade

Job Title:

job

Phone Number:

number

E-mail:

mail

Address:

address

City:

city

Country:

country

Postal Code:

cp

 

 

Organization

 

Organization Name:

org_name

Organization Address 1:

org_address

City: ​​ org_city

Country: ​​ org_country

Postal Code: ​​ org_cp

How did you learn about us?:

how ​​ 

other

Organization Website:

org_web

Institutional Officer Name:

ins_name

Institutional Officer E-mail:

ins_mail

Preferred Spanish Host Institution:

p_1 ​​ Institute of Photonic Sciences (ICFO)

p_1 ​​ Vall d'Hebron Institut de Recerca (VHIR)

p_1 ​​ Institute of Health Carlos III (ISCIII)

p_1 ​​ Institute for Neuroscience (IN)

p_1 ​​ Kronikgune Research Center

p_1 ​​ Biocruces Bizkaia (BC)

p_1 ​​ DeustoTech

p_1 ​​ Spanish National Cancer Research Centre (CNIO)

p_1 ​​ Donostia International Physic Center

p_1 ​​ Material Physic Center - Centro de Física de Materiales (MPC-CFM)

p_1 ​​ Principe Felipe Research Center (CIPF)

p_1 ​​ Spanish National Center of Biotechnology (CNB)

p_1 ​​ Institute for Sustainable Agriculture (IAS)

p_1 ​​ Institute of Mathematical Sciences (ICMAT)

p_1 ​​ Campus of International Excellence in Agrifood

Letter of Interest: (max. 1 page)

letter

Full Curriculum Vitae:

cv

PhD Diploma:

phd

Brief but concise description of the project to be developed in the Spanish host center: (max. 2 pages)

description

Project title:

project

 

 

 

In accordance with the current Regulation on the Protection of Personal Data, we inform you that your details will be incorporated into a database file under the responsibility of MUJERES POR ÁFRICA, with the purpose of managing your assistance to the Event. If you confirm your attendance and unless you state your opposition in writing to the below mentioned e-mail or through other means, we will continue to inform you of the activities and events hosted by the MUJERES POR ÁFRICA Foundation on the legal basis of the foundation’s legitimate interest. Your details will be saved until the date of the Event, and subsequently for a period of 6 years, in conformity with the applicable regulation. We will continue to provide you with information, until you unsubscribe through any valid mean.

 

Users may at any time excercise their access rights, rectification, deletion or opposition to receive information, portability and limitation of the data treatment, by addressing themselves to the MUJERES POR ÁFRICA Foundation, located in Spain, at Paseo de la Castellana 144, 28046, Madrid or by sending an e-mail to:

fundacion@mujeresporafrica.es, enclosing a document attesting their identity. You may also contact the Spanish Agency of Data Protection.

 

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