CIRM User Feedback Forum - Registration Form

Step 1: Complete personal information (required)
Asterisk () denotes a mandatory field*
First Name: *
Last Name: *
e-mail: *
Step 2: Provide additional personal information (optional)
Company or Organisation:
Country of Residence:
Phone number:
Step 3: Indicate experience with systems (optional)
Please let us know what your experience is with particular makes/models of maritime equipment and systems:
Step 4: Indicate areas of interest (tick all that apply)
Navigation equipment and systems
Communication equipment and systems
Automation equipment and systems
Step 5: Additional information
Any additional information you wish to provide on the types of product development exercises you would like to participate in?:

By submitting this form you agree to send the above details to CIRM and to register as a member of the CIRM User Feedback Forum. As a member of the Forum you may be contacted periodically by CIRM at the email address provided (any such communication will be strictly related to the User Feedback Forum). You may request to be removed from the Forum at any time by contacting CIRM.