CELTIC Domain Access Application Form

Please fill in the fields below, print the form, sign it and fax it back to:+49 6221 989 451

 

I hereby apply for permission to access the following CELTIC Domains:
Public Authority Domain CELTIC Projects Domain
CELTIC Project No.
First name: Last name:
Company: Department:
Street building/room number (if available)
Postal Code City
Country    
E-mail Fax:
Tel: Mobile:

 
Involvement in CELTIC activities (e.g. Public Authority, participant in CELTIC project CPxx, etc.):
 

If no involvement in CELTIC activities, please specify below the reasons why access is requested:
 

 

I confirm that I am involved in a CELTIC activity as indicated above. 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 CELTIC servers according to the IPR Rules of CFA. I further confirm that I will notify CELTIC immediately if the conditions for accessing the domains cease to apply (e.g. in the case of resignation from the project or the company).

I agree that I will be made responsible for any misuse of Project documents and unauthorised access to the a CELTIC Domain. In such cases my access permission will be immediately withdrawn.
Place, date    
   
 

and sign here

  

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