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Name and surname

Date of birth (dd/mm/yy)

Country of residence

Nationality

Institution /Company

Full address of Institution

Fax and phone no

Mobile phone number

E-mail address

WEB of institution

Position

Academic degree

Background of research activities on MAP (up to 200 words)

List of up to 10 most relevant references in field of MAP

Facilities/equipment used in work of MAP

Other relevant information

Participation in EU projects

Needs for collaboration within AMAPSEEC network

Suggestions for improvement and strengthen of AMAPSEEC