Organisation (*): |
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Department (*): |
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Address:
(Enter the three main lines for the
address, e.g. faculty/department
and the street address) |
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City / State (if applicable): |
State: |
Post Box (if applicable): |
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Postcode: |
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Country (*): |
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Telephone:
(include country code,
e.g. +1 for United States) |
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Fax:
(include country code,
e.g. +1 for United States) |
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Department E-mail (*): |
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Web: |
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Head of the Department: |
Title:
First Name (*):
Last Name (*):
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Number of Academic
Teaching
and Research Staff: |
Full Time:
Part Time: |
Details:
(Please attach a brief description
of your organisation/department's
field of activity, including details
of courses.) |
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Contact (*):
(Enter the title/position and
name of the contact person.) |
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Contact E-mail (*): |
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