SIB Embedded Bioinformatician application

Embedded Bioinformatician information
Name Name First Last
Employer (university, institution, etc.)
End date of employment contract (DD/MM/YY) or indicate if not known
Laboratory's name
Name of Laboratory's Director
Professional address Professional address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Office phone
Professional/Institutional email address
Private email address (will be used in case of problem with the professional address)
Information on the collaboration with SIB
SIB Group Leader's or SIB member's name SIB Group Leader's or SIB member's name First Last
SIB group's name
Starting date of collaboration Starting date of collaboration / DD / MM YYYY
End date of collaboration (if known) End date of collaboration (if known) / DD / MM YYYY
Please give a brief description of the collaboration with the SIB's group
Please insert a good quality portrait of yourself, of at least 142 x 95 pixels (height x width) for our web directory

Attach Files
Signatures

I declare that I have fully understood the SIB Member Regulations and in particular the provisions relating to my obligation of confidentiality
Signature of the embedded bioinformatician applicant
Place and Date

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Before submitting the form, please print or save this form as .pdf and collect the signatures of Group Leader and Laboratory’s Director.
Then send the signed copy by email to secretariat@sib.swiss
Signature of Group Leader
Name, Place and Date
Signature of Laboratory's Director
Name, Place and Date
Spam Protection. Please answer this simple question:
In the number 29283, what is the 2nd digit?

SIB Embedded Bioinformatician application

SIB Embedded Bioinformatician application

Embedded Bioinformatician information

Information on the collaboration with SIB

Signatures

Before submitting the form, please print or save this form as .pdf and collect the signatures of Group Leader and Laboratory’s Director. Then send the signed copy by email to secretariat@sib.swiss

Before submitting the form, please print or save this form as .pdf and collect the signatures of Group Leader and Laboratory’s Director.
Then send the signed copy by email to secretariat@sib.swiss