| General informations | |
| Company name* | |
| Address* | |
| City* | |
| Zip code* | |
| Website | |
| Workforce* | |
| Creation date* | |
| Siret number* | |
| VAT number* | |
| Main activity* | |
| Segmentation | |
| Application domain* |
Single choice Biotech - Pharma Digital Healthtech MedTech In vitro Diagnotics |
| Type of activity* |
3 possible choices CMO - Production - Bioproduction CRO - Tools - R&D platform Diagnostics E-Health Food products Medical device Nutrition & Health products Technology provider Therapeutics, Pharma or Biotech |
| Contacts | |
| Company manager | |
| Lastname* | |
| Firstname* | |
| Job title* | |
| Email* | |
| Phone* | |
|
Administrative contact To be completed only if different from the manager of the company |
|
| Lastname | |
| Firstname | |
| Job title | |
| Phone | |