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Application

Name*

Organization*

E-mail*

Street*

Postal code*

City*

Country*

Project Name*

Project Timeframe*

Team Profile* Will you be carrying out this project as a member of a team or as an individual? If you are part of a team, please answer the following: * how many participants will be working together? * Who are they? * What is their function?

Project description*

What are you requesting from Straumann Group?*

Do you believe this project satisfies the Straumann Group Guidelines on charitable support?*

Is the project related to dental care?*

Have you already requested support from someone in the Straumann Group?*

Have you received support from other sources?*

If so, who?*

Was it in the form of goods or funding?*

What was the value of that support?*

Who will be responsible for this project?*

Guidelines*

I have read and understand the guidelines.

Data usage agreement*

I acknowledge that my data will be processed according to the terms and conditions of the Privacy notice.

Read our Privacy notice.

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Charitable project support

Straumann® AID program

Application