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Submit proposal for a research collaboration

Please fill out the following form and click the ″Confirm″ button.

Your Information

Name 【Required】

Company / Organization name 【Required】

*Please fill in Organization Name and department / classroom / course.

Contact information 【Required】

■Telephone

Location (Head office) 【Required】

■Postal code
■Address
■Country Name

Website

Material Information

Subject of research 【Required】

Classification

*Please check the appropriate classification(s).

Stage of research

*Please select the appropriate stage.

Disease area

Expected indication

Expectations from the company

Attachments 【Required】
*File Size: Total 2MB

*Template / other; either is acceptable

Intellectual property

Research grants from public institutions

Cooperating organizations such as a technology licensing organization(TLO)