Request for a new access
(Step 1/3)

 
* Denotes Required field.
Last name: 
 
First name: 
*
 
Title: 
*
Eurodyssée contact
 
Greeting: 
For example “President”, “Doctor”, “Lord”...
 
Email: 
*
 
Email (confirmation): 
*
Please submit your direct email address for the use of the AER Secretariat. This email will not be published if you fill in the field “Public email address” below.
 
Password: 
*
A valid password must be at least 8 characters long, mixing letters and numbers and having at least a non alphabetic caracter or an upper case caracter.
 
Password confirmation: 
*
 
Localisation géographique: 
 
Continent: 
 
Country: 
 
Region: 
 
 
Compte suggéré par: 
 
Mailing language: 
*
 
Substitution language: 
*
 
Maternal language: 
 
Nationality: 
 
Public email: 
Here you can specify a public electronic address if you want it to appear on Visiting Cards.
 
Your photo: 
 
Curriculum vitæ: 
 
Name: 
*
Type de structure: 
 
Function: 
*
 
Detailed function: 
 
Prise de fonction le: 
*
 
 
Organisation name: 
*
 
Department / Service: 
 
Address: 
*
 
 
 
 
 
 
 
Post code: 
*
City: 
*
 
Country: 
*
 
Phone number: 
Internat. Phone code
Phone number
*
Phone type
 
Optional mobile number: 
Internat. Phone code
Mobile number
Can be published on AER website
 
Fax number: 
Internat. Phone code
Fax number
 
Facebook
 
Twitter
 
LinkedIn
 
 
 
 

 
Home | My account | Faq | Site Index


Assembly of European Regions - 6 Rue Oberlin - F-67000 Strasbourg / 63-67 rue d'Arlon - B-1040 Bruxelles / info@aer.eu
All rights reserved © Assembly of European Regions (AER) 1999-2015 (Read Legal information and Disclaimer)
Development CMS Typo3 Ameos and AER - webmasterdelete_me(at)aerdelete_me.eu