Centre International de Neurobiologie Appliquée selon Dr. Klinghardt
International Center for Applied Neurobiology according to Dr. Klinghardt
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Application Form

Adhesion form to the International Federation of Neurobiology

THE NATIONAL ORGANIZATION (NO)
1. General information
Candidate's country:
Name:
Address of the registered office:
Phone:
Fax:
E-mail:
Website:
Opening hours:
The permanence is assured by…

2. Legal statutes
Corporate name:

THE DIRECTION COMMITTEE OF THE NO
1. Director
Surname: Name:
Address:
Phone: Fax:
E-mail: Profession:

Formations followed in the domain of Dr. Klinghardt's method:
Name and level of the course
Organized by
Country
Date

2. Other members of the direction committee
Surname, Name: Function:

DEVELOPMENT PROJECTS
Intented actions and schedule:
In which language would you like to receive the following documents: