iMEdD BRIDGE FORM

Entity’s brand name*

Type of entity*

e.g. Institution, Association, Non-Profit Organisation, etc.

Headquarters*

country, city, postal code, number, street, floor

Telephone number*

Mobile phone number*

Email*

VAT No.*

Tax Office*

Year of establishment*

Website

Name*

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 history

Project description*

Requirements - needs*

Indicative schedule*

Indicative budget*

Collaboration content / Possible methods of collaboration with the iMEdD team*

Potential partners

Attach files

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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*

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Comments

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