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1. CONTACT INFORMATION
(Note: Type NA, if the field not applicable)
Title
*
First Name
*
Last Name
*
Organization/Company
*
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*
FTE
*
Amount
Enter FTE to view amount
Mode Of Payment
Credit Card Type
(Credit card number must not contain blank spaces or hyphens)
Cardholder Name
*
Credit Card No
*
Card Identification No
Expiry Month
Expiry Year
Draft No
*
IssueDate
mm/dd/yyyy
IssueBank
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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-
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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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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.