EURESCOM Information and Communication Services (EICS) Access Application Form

Please fill in the fields below, print the form, sign it and fax it back to:+49 6221 989 209


I hereby apply for permission to access the EURESCOM Information and Communication Services (EICS)


First name: Last name:
Company: Department:
Street building/room number (if available)
Postal Code City
E-mail Fax:
Tel: Mobile:


Involvement in EURESCOM activities (e.g. representative, participant in project Pxxx, etc.):

If no involvement in EURESCOM activities, please specify below the reasons why access to the EICS is requested (e.g. for research activities in the company, other co-operation Projects, etc.):


I confirm that I am employed by a EURESCOM Shareholder or an affiliated company of a EURESCOM Shareholder. I confirm that I am not allowed to give the login name and password for access permission to anybody else, not even to a colleague of my company. I confirm that I will use the transferred documents from the EICS servers according to the IPR Agreement of EURESCOM. I further confirm that I will notify EURESCOM immediately if the conditions for accessing EICS cease to apply (e.g. in the case of resignation from the Shareholder or its company).

I agree that I will be made responsible for any misuse of Project documents and unauthorised access to the EICS. In such cases my access permission will be withdrawn.

Place, date    

and sign here