Mandate and Contact Information (Form 1 of BASELINE UVA)

If you are representing a project funded by the EC:
 
Programme, Project Number and Name:
Otherwise:
 
Company name and address:
Name of Contact Person (who filled in this form):

E-mail:

Telephone:

Fax:

I declare that the Contact Person described above is mandated by the Project / Company to provide the enclosed data and that the Project / Company allows the BASELINE project to use the enclosed data in order to pool data on user validation techniques and methods, costs, and benefits in an anonymised format so that the identity of the participating organisations and projects is not revealed.

(Please keep a copy of your letter of mandate from the project in your files.)

Date:

Signature:

Position in Project / Company:

Return to Structure of UVA Form.