DESWARE ON-LINE REGISTRATION FOR INSTITUTIONS
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Your Privacy is Guaranteed
1. CONTACT INFORMATION
(Note: Type NA, if the field not applicable)
Title
*
First Name
*
Enter Firstname
Last Name
*
Enter LastName
Organization/Company
Address
City
Province/State
Postal code
Country
Phone Number
Fax Number
Email Address
*
Enter emailInvalid email
Confirm Email Address
*
Administrator Details
Name
*
Enter administrator name
Email
*
Enter administrator emailInvalid email
Phone
No
*
Enter administrator phone
How did you hear about DESWARE
*
Please select one entry
If "Other" please specify
*
You must specify this field
Username must be between 6-12 characters with no blank spaces
Preferred Username
*
Enter Username
(Username must be
between 6 - 12 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*
Select Plan
Amount
Mode Of Payment
Credit Card Type
Cardholder Name
*
Enter cardholder name
* You must type creditcard number without blank spaces
or hyphens
Credit Card No
*
Enter Credit Card no Invalid Credit Card No
Card Identification No
Expiry Month
*
Expiry Year
*
Draft No
*
Enter Draft No
IssueBank
*
IssueDate(mm/dd/yyyy)
*
Invalid Date- Draft must not be earlier or later than six months
Institution IP Addresses and/or Ranges
Domain Name (e.g.www.mydomain.edu)
*
Enter domainInvalid domain format
For Institutional subscribers require an IP Address, please print
out the attached PDF version, fill the
information and return to the address stated at the end of the page
To enter Range address click on the checkbox to enable the second
IP address box
1.
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.
*
IP requires 4 partsIncomplete IPEnter IPIP required
2.
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3.
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Does your institution have a Firewall Server?
Thank you for your order
For your convenience, subscription will be automatically renewed
until you request cancellation. [For cancellation, send an email to
]
Alternatively:
A downloadable Registration Form in
PDF or
Word is
available.
Please Fax/Mail the form to
UNESCO-EOLSS Joint Committee Secretariat
UNESCO-Encyclopedia of Life Support
Systems (EOLSS)
E-mail:
/
By Mail - Bank drafts payable to
UNESCO-Encyclopedia of Life Support Systems
(EOLSS)
Drafts must be in EUROS/UKP/UK$. International money orders are also accepted.
Email - Direct your order and credit card details to:
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
*
Enter verification code
(Note: If you cannot read the numbers in the above
image, reload the page to generate a new one.)
OR Print and Fax with your signature.
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.