DESWARE ON-LINE REGISTRATION FOR INSTITUTIONS
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1. CONTACT INFORMATION
(Note: Type NA, if the field not applicable)
Title
*
First Name
*
Last Name
*
Organization/Company
Address
City
Province/State
Postal code
Country
Phone Number
Fax Number
Email Address
*
Confirm Email Address
*
Administrator Details
Name
*
Email
*
Phone
No
*
How did you hear about DESWARE
*
If "Other" please specify
*
Preferred Username
*
(Username must be
between 6 - 12 characters with no blank spaces)
2. PROFILE (Activity)
Please select the one response below which best describes your
activity:
If "Other" please specify:
Primary Job Function
If "Other" please specify:
From the list of subject categories below please select the ONE
which best describes your area of work or study
3. PAYMENT*
Select Plan
Amount
Mode Of Payment
Credit Card Type
Cardholder Name
*
* You must type creditcard number without blank spaces
or hyphens
Credit Card No
*
Card Identification No
Expiry Month
*
Expiry Year
*
Draft No
*
IssueBank
*
IssueDate(mm/dd/yyyy)
*
Institution IP Addresses and/or Ranges
Domain Name (e.g.www.mydomain.edu)
*
For Institutional subscribers require an IP Address, please print
out the attached PDF version, fill the
information and return to the address stated at the end of the page
To enter Range address click on the checkbox to enable the second
IP address box
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Does your institution have a Firewall Server?
Thank you for your order
For your convenience, subscription will be automatically renewed
until you request cancellation. [For cancellation, send an email to
]
Alternatively:
A downloadable Registration Form in
PDF or
Word is
available.
Please Fax/Mail the form to
UNESCO-EOLSS Joint Committee Secretariat
UNESCO-Encyclopedia of Life Support
Systems (EOLSS)
E-mail:
/
By Mail - Bank drafts payable to
UNESCO-Encyclopedia of Life Support Systems
(EOLSS)
Drafts must be in EUROS/UKP/UK$. International money orders are also accepted.
Email - Direct your order and credit card details to:
Please read the following carefully:
I understand that completion of this form is a binding agreement and I offer my
personal e-mail address in lieu of a signature:
Enter the Code Shown above
*
(Note: If you cannot read the numbers in the above
image, reload the page to generate a new one.)
OR Print and Fax with your signature.
NOTE:
Please use an active email address when
registering to EOLSS. An activation email will be sent to the email address
associated with your account to provide you access to the service.
Please also ensure that any email spam filters are properly configured to
ensure that you recieve the activation email from EOLSS.
