Fundación Index Declaration

Name (*)
Surname (*)
Email (will not be visible) (*)
Degree or Job
Institutional affiliation (*)
City (*)
Country (*)
Select one of next options (*)	Signed individually Signed in the name of organization that I have outlined avobe Signed individually and signed in the name of organization that I have outlined avobe
* By checking this box, I confirm that I am the person whose name is inscribed above and authorize Fundación Index to show my name, degree and / or affiliation as a signatory of DEGRA. If I am signing in the name of my institution, I confirm that I have the authority to do so.
I authorize Fundación Index to email updates and news about DEGRA and other related activities.
	Fill in the required fields correctly and check the confirmation box before sending.