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Become a member
Only Representative Association Supporting Membership Form
Please fill out the form below:
I. Company General Information (*)
Company
Name
(required)
Address
Foundation Date
Phone Number
Fax Number
E-mail
(valid email required)
Website
President, Managing Director or Equivalent
Name
Phone Number
Fax Number
E-mail
(valid email required)
If different: Only Representative Contact Detail
Name
Phone Number
Fax Number
E-mail
Company Structure/Organization Type
Organizational Form of the Company
Number of Employees
Company Registration Number
Subsidiary of / Independent
II. Membership Type
Number of persons involved in the REACh activities
Does your company have REACh activities for at least 2 years?
||
Yes
No
Do you have at least one staff member with more than 5 years of regulatory
experience in the field of cosmetics?
Yes
No
Are you offering Only Representative services?
||
Yes
No
Have you notified your relevant Competent Authority about your REACh activities?
Yes
No
Are you present in any activities, groups, committees at National, European and
International level regarding cosmetics? Which?
III. Other Activities
What other services do you provide? Please indicate all that apply:
Distribution / Marketing
Yes
No
Regulatory Consulting
Yes
No
Advisory Services on GMP EN/ISO 22716
Yes
No
Clinical Studies Services
Yes
No
Responsible Person
Yes
No
Safety Assessment
Yes
No
Others (please specify)
IV. Other information
How did you learn about ERPA?
What are your reasons for wanting to join ERPA?
What do you wish to achieve through your participation in ERPA?
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