Salutation*:

Mrs

Mr

Title:

First name*:

Name*:

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De

Fr

It

En

Present professional activity*

Qualifications (e.g. Bachelor, Master)

Further training in ergonomics *

University level education in ergonomics

Ergonomics course lasting 20 days or more

Other:

Principal domains of competence in ergonomics

Physical Ergonomics

Cognitive Ergonomics

Organisational Ergonomics

Work Organisation

Workplace design

Occupational Rehabilitation

VDU Work

Health protection and promotion

Indoor (climate, noise, light...)

Human reliability

Product design

Software Ergonomics

Other:

CREE Certification*

Yes

No

I offer the following services in ergonomics

Physical Ergonomics

Cognitive Ergonomics

Organisational Ergonomics

Work Organisation

Workplace design

Occupational Rehabilitation

VDU Work

Health protection and promotion

Indoor (climate, noise, light...)

Human reliability

Product design

Software Ergonomics

Other:

I want my personal information to be published on the Internet*

Yes

No

I want to receive the IZA publication (free of charge)*

Yes

No

Recommendation (by another member)

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