Form to publicly express interest for authorisation applications

Fields marked with an asterisk (*) are mandatory.

This is an update of previously submitted information

 Which substance in the Authorisation list or substances recommended for inclusion in Authorisation list are you interested in?
* Substance(s)
several choices possible
 Use(s) to be included in the application

Please list the use(s) for the above mentioned substance(s) you anticipate to be included in your future application.

* Total number of uses
 Contact information
* Name of Company
* Country of legal establishment
* Contact person
* Email
* Confirm email
Telephone number (optional)
Website (optional)
* Type of organisation
* Role in the supply chain
several choices possible
* Collaboration type
several choices possible
 Additional information
Any further information:
 Terms & Conditions
I have read and accept the following Terms of Use and Legal Notice

The submitter of the information via this webform agrees that ECHA publishes on its website all provided information. The submitter also warrants that the information provided is to its best knowledge correct and up to date. The provided information creates no legal rights or obligations for the submitter.

The submitters of the information agree that ECHA shall not be held liable for any damage that the publication or use of this information might cause to the information submitter or other third parties. Published information may be removed by ECHA on request from the submitter of the information sent to the following email address: data-protection-officer@echa.europa.eu.

The processing of any personal data submitted via this webform is subject to the conditions specified in the Personal Data Protection Notice described in the Legal Notice).