User registration

Registration Form

* Required Fields

Salutation*
(Mr., Mrs., Dr., Prof., etc.)

First Name*

Last Name*

Phone number*

Email address*

Password*

Confirm password*

User kind*

Host institution*

Address*

City*

ZIP Code (C.A.P.)*

State or Province*

Country*

Privacy Policy

Having acknowledged the Terms of Service and Privacy Policy, data subject freely:

give consent *	does not give consent
to registration and subsequent access to the website

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to handling the request for contact with the biobank

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to processing: sending newsletters and communications via phone, regular mail and email