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Company Details/lQS`1.1 Organization Name/lQSTyFull Name/hQTParent Organization/;`lQSType of Organization/lQS{|WSME/-N\ON FORMCHECKBOX  Large company/'YlQS FORMCHECKBOX  Other/vQN  FORMCHECKBOX  1.2 Organization Address/:gg0W@WStreet/WSZip or Postal Code/City/W^1.3 Contact Person Data/T|NOo`Name/YTFunction/LRDirect phone Number and Mobile Number/v~5u݋bKb:gE-mail/5uP[N1.4. Website/Q@W1.5 Organization Background/lQS̀ofYear Established/bzeNo. of Employees/s gXT]peNo. of R&D Personnel/xSNXTpeStage (Seed, Revenue, Pre-Clinical, Clinical)/ONSU\@bY6kGeneral Information/ONW,gOo`Core Business & Area of Expertise/;N%NRTNNWMain Products / Services/;N%NTTgRComments/vQNf2. The Project/b=myv2.1 Main Technological Area/yv@b^\b/gW2.2 Description of the proposed joint commercially focused R&D project/{bTTxSvyvQ[3. Potential Partner/Company/aTT\OO4O/lQS3.1 Main Characteristics and specific technological expertise/NelQS^wQYvagNTNNW3.2 What is the specific R&D contribution you are seeking/NelQS(WyvT\O-Nbbv]\O3.3 Companies/Organisation you are already in contact//f&T] gT|USMOI hereby provide my consent to disclose this form to third parties in the process of identifying potential partners for the proposed project:NN[~bT\OO4O b(Wh,#CJPJaJhmH sH nH tH _HCJPJo(aJhmH sH CJPJo(aJhmHsHCJPJaJhmHsHnH tH CJPJaJhmH sH nH tH CJPJo(aJhmH sH CJPJo(aJhmH sH CJPJaJhmH sH nH tH CJPJaJhmH sH nH tH CJPJo(aJhmH sH CJPJo(aJhmH sH CJPJaJhmH sH nH tH CJPJo(aJhmH sH CJPJo(aJ5hmH sH H R T p r t ɯyeS9%&CJPJaJhmH sH nH tH _HU2j|UCJPJaJhmH sH nH tH _H#CJPJaJhmH sH nH tH _H&CJPJaJhmH sH nH tH _HUCJPJo(aJhmH sH _H#CJPJaJhmH sH nH tH _H&CJPJaJhmH sH nH tH _HU2jUCJPJaJhmH sH nH tH _H#CJPJaJhmH sH nH tH _H&CJPJaJhmH sH nH tH _HUCJPJo(aJhmH sH _H       ͽ{k]K?1CJPJaJhnH tH _HCJPJaJhnH tH #CJPJaJhmH sH nH tH _HCJPJaJhnH tH 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