VOLUNTARY PARTICIPATION FORM

1. NAME SURNAME *
2. PHONE NUMBER *
3. E-MAİL ADDRESS *
4. THE CITY WHICH YOU ARE LIVING *
5. YOUR JOB *
6. YOUR MESSAGE COULD NOT BE SENT. PLEASE TRY AGAİN. *
7. DO YOU WORK VOLUNTEER IN ANY CIVIL SOCIETY ORGANIZATION OR PATIENT ASSOCIATION BEFORE? WHERE ? *
8. DO YOU RECOMMEND THE PROJECT / IDEA RELATED TO THE NETWORK OF RARE DISEASES? WHAT YOU CAN SUPPORT US? *
11. I ACKNOWLEDGE AND ACKNOWLED THAT I HAVE ACKNOWLEDGED THE COMMUNICATION OF THE PERSONAL DATA THAT I GIVEN TO THE NETWORK FOR RESEARCH, SERVICES AND WORKING ON ITS IMPLEMENTATION. *
     
Eskişehir Web Tasarım