Expression of Interest | Boost4Health

Complete this form if you want to join Boost4Health. Your local partner will contact you.

Is your organisation an SME or is the group your organisation is part of an SME under the European definition? *

Yes

Organisation Name *

Contact Name *

Your position in the organisation *

Email address *

If you already have a Boost4Health profile use a different e-mail address

Telephone number: (including international dialing code) *

Street *

Number *

Postal code *

City *

Website *

Region *

In what year was your organisation established? *

Month

Day

Year

How many people does your organisation employ? *

What is your annual turnover? (most recent available figure) *

In what field does your business operate? *

Please give a brief description of your main products or services: *

Which step of the venture cycle best describes your main products or services? *

What kind of support Boost4Health offers are you interested in? *

Coaching

Travel voucher

Market expertise voucher

Product validation voucher

How did you hear about the Boost4Health project? *

Confirmation *

I am happy for Boost4Health Partners to contact me to keep me informed about the Boost4Health Project by Email or Phone. Our Privacy Statement is available here. I acknowledge that I have the right to withdraw my consent for Boost4Health Partners to hold or process my personal information.