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EURESCOM Information and
Communication Services (EICS) Access Application Form
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Please fill in the fields below, print the form, sign it and fax it back
to:+49 6221 989 209
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I
hereby apply for permission to access the EURESCOM Information and
Communication Services (EICS)
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| First name: |
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Last name: |
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| Company: |
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Department: |
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| Street |
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building/room number
(if
available) |
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| Postal Code |
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City |
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| Country |
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| E-mail |
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Fax: |
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| Tel: |
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Mobile: |
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| Involvement
in EURESCOM activities (e.g. representative, participant in project Pxxx,
etc.): |
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| If no
involvement in EURESCOM activities, please specify below the reasons why
access to the EICS is requested (e.g. for research activities in the
company, other co-operation Projects, etc.): |
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I confirm that I am employed by a EURESCOM
Shareholder or an affiliated company of a EURESCOM Shareholder. I
confirm that I am not allowed to give the login name and password for
access permission to anybody else, not even to a colleague of my
company. I confirm that I will use the transferred documents from the
EICS servers according to the IPR Agreement of EURESCOM. I further
confirm that I will notify EURESCOM immediately if the conditions for
accessing EICS cease to apply (e.g. in the case of resignation from the
Shareholder or its company).
I agree that I will be made responsible for any
misuse of Project documents and unauthorised access to the EICS. In such
cases my access permission will be withdrawn. |
| Place, date |
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| and sign here |
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