iMEdD BRIDGE FORM Entity’s RecordEntity’s brand name* Type of entity* e.g. Institution, Association, Non-Profit Organisation, etc.Headquarters* country, city, postal code, number, street, floorTelephone number* Mobile phone number* Email* VAT No.* Tax Office* Year of establishment* Website Legal representative’s detailsName* Surname* Email* Telephone number* Mobile phone number* VAT No.* Tax Office* Entity’s Identity*background, activity, means of achievement, etc.Vision - Mission - Goals*Team and roles*Network of Partners*brand name, collaboration historyProjectProject description*Requirements - needs*Indicative schedule*Indicative budget*Collaboration frameworkCollaboration content / Possible methods of collaboration with the iMEdD team*Potential partnersAttach files Drop files here or Select files Max. file size: 50 MB. You can attach any file you consider relevant and may reinforce your proposal. (doc, xls, ppt, pdf, jpeg)Terms for expression of interest* I have read and accept the Terms For Expression Of Interest In Participating In Imedd’s Bridge Programme/Pillar Privacy policy* I have read and understood the Privacy Policy of iMEdD PhoneThis field is for validation purposes and should be left unchanged. Δ
