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: | ||
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 |
| ||||
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. |