The Istay@home Request for Information

General Information

Question Title

* 1. Please provide information on the following.

Company name

Short description (max 1000 characters)

Address

URL

Contact

Company established since

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* 2. In which of the following countries do you operate?

Belgium

Germany

France

Great Britain

Netherlands

Other Countries (please specify)

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* 3. How many employees are there in your company?

Write in number

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* 4. What is the annual turnover of your company?

Write in for each year below

2010

2011

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* 5. Please state the number of Ambient Assisted Living (AAL) products offered by your company

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* 6. What are the names of these products?

Write in below

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* 7. Contact details of the person completing the form

Name

Job title

Telephone

Question Title

* 1. Please provide information on the following.

Question Title

* 2. In which of the following countries do you operate?

Question Title

* 3. How many employees are there in your company?Write in number

Question Title

* 4. What is the annual turnover of your company?Write in for each year below

Question Title

* 5. Please state the number of Ambient Assisted Living (AAL) products offered by your company

Question Title

* 6. What are the names of these products?Write in below

Question Title

* 7. Contact details of the person completing the form

* 3. How many employees are there in your company?

Write in number

* 4. What is the annual turnover of your company?

Write in for each year below

* 6. What are the names of these products?

Write in below