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1. CONTACT INFORMATION
(Note: Type NA, if the field not applicable)
Title
*
First Name
*
Last Name
*
Organization/Institution Name
*
Dept./Library Name
*
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 find about
EOLSS
*
If
"Other" please specify:
*
Preferred User Name
*
(Username must be minimum 8 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*
Coupon Code
FTE
*
*FTE: Full Time Equivalent (Faculty, Researchers and all
Students in the case of educational institutions)
Duration
Amount
Enter FTE to view amount
Mode Of Payment
Credit Card Type
(Credit card number must not contain blank spaces or hyphens)
Card holder Name
*
Credit Card No
*
Card Identification No
Expiry Month
Expiry Year
Draft No
*
Issue Date
mm/dd/yyyy
Issue Bank
For your convenience, subscription will be
automatically renewed until you request cancellation.
[For cancellation, send an email to
]
For any institution/organization to access EOLSS Online, we use two
methods of authentications: IP authentication and remote patron authentication
(RPA). If your institution is using remote patron authentication (RPA), please
contact
or
Institution IP Addresses and/or Ranges
Domain Name(e.g.www.mydomain.edu)
*
To verify your IP Address click
here
Examples of valid IP Addresses
(For information on how to enter IP
Address click
here)
Single Station
.
.
.
Class B Networks
.
.
.
Class C Networks
.
.
.
IP Range
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or
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.
.
To enter Range address click on the checkbox to enable the second
IP address box
1.
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*
2.
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3.
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For additional IP address please contact
Does your institution have a Firewall or
Proxy server?
If yes, enter the IP address of the Firewall or Proxy
.
.
.
Thank you for your order
Alternatively:
A downloadable Registration Form in
PDF or
Word is
available.
For Further Information contact:
Drafts must be in EUROS/UKP/US $.
International money orders are also accepted.
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 Email with your
signature to
.
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.
