Circular Economy Research & Innovation Group Registration

Page 1: Registration Form

1.1. Title

2.2. Forename

3.3. Surname

4.4. Known as (if different to forename)

5.5. Job title

6.6. Organisation

7.7. Address

8.8. Town/City

9.9. Postcode

10.10. Telephone number

11.11. Email

12.12. Please subscribe me to the Circular Economy Research and Innovation Group Wales email list:

Yes

No

This part of the survey uses a table of questions, view as separate questions instead?

13.13. Directory of membership

Error Error

	Yes	No
I consent for my contact details to be included in a directory of membership
I consent for my contact details to be shared with the rest of the group
I consent for my contact details to be publicly accessible