This form is to be completed by ALL EuroPrevall members only.
Title*
Select Prof Dr Mr Ms
Name*
Email *
Password*
Position*
Gender*
Male Female
Contact Information
Please include the International dialing code
Telephone*
Fax
Mobile Telephone
Country*
Organisation*
Organisation Website
Which Europrevall activities are you involved with?
Theme 1 - WP1.1
Theme 1 - WP1.2
Theme 1 - WP1.3
Theme 2 - WP2.1
Theme 2 - WP2.2
Theme 3 - WP3.1
Theme 3 - WP3.2
Theme 3 - WP3.3
Theme 4 - WP4.1
Theme 4 - WP4.2
Theme 4 - WP4.3
Theme 5 - WP5.1
Theme 5 - WP5.2
Theme 5 - WP5.3
Theme 5 - WP5.4
Theme 5 - WP5.5
Theme 5 - WP5.6
Theme 5 - State of the Art Papers
Management
Specify your areas of interest
keywords*
Average amount of time spent on EuroPrevall (FTE - full time equivalent)
Less than 0.2 fte = less than 1 day a week Between 0.2 fte and 0.4 fte = 1 to 2 days a week Between 0.4 fte and 0.6 fte = 2 to 3 days a week Between 0.6 and 0.8 fte = 3 or 4 days a week More than 0.8 fte = 4 days a week or more
Time
Select Less than 0.2 fte Between 0.2 fte and 0.4 fte Between 0.4 fte and 0.6 fte Between 0.6 and 0.8 fte More than 0.8 fte
Gender issue position information
Manager (is responsible for the management or organisation of a project or process, can be the WP leader or manager of the secretariat for example)
Early researcher (has worked as a researcher for less than 4 years after your PhD)
Technical staff (supports the technical aspect of the research process or project, for example a lab assistant or a system integrator)
position
Select Manager (WP leader or manager of t... Professor Associate Professor Experienced researcher Early researcher (< 4 years after ... PhD Student Technical staff Secretary or administrator Consultant clinician Clinician (other) (please specify) Other (please specify)
Other (please specify)
