Application to join OCEAN2012

^* Please complete the highlighted fields

Your detailsName of your organization: *

Website http:// *

Street: *

Town: *

County / State:

Postcode / ZIP code: *

Country: *

Email: *

Telephone Number: *

Key contact

Contact name: *

Email: *

Telephone Number: *

Mobile Number:

Address:

Media liaison contact

Name of media liaison contact:

Email:

Telephone Number: Mobile Number:

Address:

Policy liaison contact

Name of policy liaison contact:

Email:

Telephone Number:

Mobile Number:

Address:

Web liaison contact

Name of web liaison contact:

Email:

Telephone Number:

Mobile Number:

Address:

About you

What can your organization contribute to achieving the objectives of OCEAN2012?
Describe the added value you would bring to the coalition.

How could this contribution be enhanced by OCEAN2012 (including possible additional resources)? Describe possible results that could be achieved.

Anything else we should know about you?

Please provide two references with contact details.

*

*

Agreed to for the organization referred to above by:

*

Please enter the code show in the image below:

*

Agreement with Vision, Mission, Objectives and Co-operation Protocol

I confirm that my organization supports OCEAN2012's vision, mission and objectives set out in OCEAN2012's Statement of Purpose.^*

Identity Leaflet available in: English / French / German / Italian / Spanish

I confirm that my organization understands and agrees to abide by OCEAN2012's Co-operation Protocol.^*