Registration Form

Service *

* To register with Genome Analysis Platform, please use this form instead.

User data

Name *
Surname *
Dept./Unit *
Address *
Postal code *		City *
Telephone *		Ext.
Fax
E-mail *

Invoice Data

Centre/Institution *
NIF/CIF/VAT number *
Address *
Postal code *		City *
Telephone *		Ext.
Fax
E-mail *
Bank Account Number *

Send

In accordance with the arranged text in Statutory law 15/1999 of 13 of December, about Protection of Personal Data, be aware that we will conserve your personal data in a file which CIC bioGUNE is responsible (ASOCIACIÓN CENTRO DE INVESTIGACIÓN COOPERATIVA EN BIOCIENCIAS). You have right to access these data, to rectify them or to cancel them; to do so, please write to the Administration Department of CIC bioGUNE, Technological Park of Bizkaia, Ed. 801-A, 48160 Derio (Bizkaia).