INTERREG IVC Info Point East

REGISTRATION FORM

Lead Applicant Seminar and/or Individual Project Consultation

A: Registration details

Please complete this form in full. We can only confirm consultations where the information below is complete. The Lead Applicant Seminar and the Individual Project Consultations will be held inBucharest/ Romania. Seminar will take place on 5thNovember and individualconsultations will be held on5th November (after the Seminar) and on 6th November.

Registration deadline: 24.10.2008

Please, mark the selected field according to your choice.

5November 2008 Seminar

Individual consultations (after the seminar)

6November 2008 Individual consultations

2 Contact details

Surname / first name:
Organisation:
Address:
Postcode / Town:
Country:
Email: / Tel:
Mobile phone: / Fax:

3 Accompanying persons

Please provide the name and email address of the people accompanying you to this consultation (if applicable):

1.

Surname / first name:
Organisation:
Address:
Postcode / Town:
Country:
Email: / Tel:
Mobile phone: / Fax:

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2.

Surname / first name:
Organisation:
Address:
Postcode / Town:
Country:
Email: / Tel:
Mobile phone: / Fax:

Please note that you will receive confirmation of your request by email. Please do not make any travel arrangements until you have received this confirmation. For the Lead Applicant Seminar the number of persons per project may have to be limited.

B: Description of the project idea

Possible project acronym: / Possible Lead Partner:
Please select the type of intervention you intend to apply for:
Regional Initiative Projects
Capitalisation Projects
Please select the sub theme you intend to apply for (only one sub-theme should be selected):
Priority 1 / Innovation, research and technology development
Entrepreneurship and SMEs
Information society
Employment, human capital and education
Priority 2 / Natural and technological risks (incl. Climate Change)
Water management
Waste management
Biodiversity and preservation of natural heritage (incl. Air Quality)
Energy and sustainable transport
Cultural heritage and landscape

Please develop the regional development issue tackled by the project (10 lines maximum):

Please describe the main objectives of the project (10 lines maximum):

Please describe shortly the partnership envisaged (i.e. nature and location of the partners) (10 lines maximum):

Please describe the main activities planned in the project (15 lines maximum):

If you would like to ask further questions to the INTERREG IVC JTS / Information Point East, please list them below (thank you for being as precise, clear and understandable as possible):

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Please return the form to:

INTERREG IVC – Individual Consultation form – p.1/3

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