ALTA : Application Form

Application Form

Sharing your visions

Do you have an innovative research idea in the field of Alpha-1-Antitrypsin Deficiency?

In order to participate in the ALTA 2020-2021 cycle please fill in the Letter of Intent (LOI) form on this website, specifying if your project is a CLINICAL project or a BASIC Research one

Should you have any questions regarding the application process, please do not hesitate to contact us..

Applicant Information (*)

Applicant name Applicant surname Email

Letter of Intent (*)

Curriculum Vitae (*) (Allowed Filetypes are Word, PDF or RTF; this file must be smaller than 20 MB)

How did you hear about the ALTA Award? (*)

Grifols website Informed by a Grifols sales rep Informed by other Grifols employees Informed by my institution Informed by a colleague At a congress Scientific Society Other

Enter the 4 numbers in the picture

I have read and accept the Privacy Notice. I confirm that I have read and accepted the Terms and Conditions of participation in the scientific award. I also assure that the statements in this application are true, complete and accurate.

DATA PROTECTION INFORMATION
Data controller	Grifols, S.A.
Purpose	To manage and control the participation in the awards you have registered.
Legal basis	Consent of the data subject.
Recipients	Grifols' group companies and providers of products and services.
Rights	To access, rectify and erase personal data, as well as other rights detailed in the additional information section.
Additional information	You can find additional and detailed information on data protection here.

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