Become a partner

Partnership form

Join BioWin

Please complete the following form to send us your partnership application. BioWin partnership is open to Walloon businesses and institutions that do not have R&D activities but still contribute to health innovation in the region. Organisations outside Wallonia that are interested in developing activities in the region are also welcome to join.

General information

Company/Organisation name *

Street *

Number *

City *

Zip code *

VAT number *

Number of FTEs *

Website *

Company email address *

Company phone

Description of activities (max 100 words)

Motivation for joining BioWin

Company/Organisation's manager

First and last name *

Job title *

Email address *

Phone *

Main contact

Same as the Company/Organisation's manager

First and last name *

Job title *

Email address *

Phone

Special request

I agree to the privacy policy. By submitting this form, I confirm that I have read and I accept BioWin’s internal regulations and the general terms and conditions of BioWin membership.