LASERLAB-EUROPE – Access to Research Infrastructures

Users’ Personal Details

Project ID		

Visiting Researcher (= User):

Family Name		
First Name		
Gender (m/f)		
Year of birth		
Nationality		
E-Mail Address		
New user (yes/no)		
Group leader (yes/no)		

Researcher status:	(please tick)	
	Undergrad. 		
	Postgrad.		
	Postdoc 		
	Experienced Researcher		
	Technician 		

Scientific Background:	(please tick)	
	Physics 		
	Chemistry 		
	Life Sciences + Biotech		
	Earth Sciences + Environment		
	Engineering + Technology		
	Mathematics 		
	Information + Communication Technol.		
	Material Sciences		
	Energy		
	Humanities		
(If several disciplines are specified, 1, 2, … may be used to indicate a priority order)	

Home institution 
(Organisation, 
Department)
		
Town and country of home institution

Legal status of home institution:	(please tick)	
	University		
	Public Research Organisation 		
	Private Research Organisation		
	SME 		
	Other