
What technical area (environmental chemistry or laboratory chemical safety) does your facility service? *
Where is your facility located (city, state, country)? *
Please provide your contact information (address, phone, and especially e-mail). *
Is there a particular developing country and/or contact there of interest to you? *
Please describe the kind of help that you can provide to a visiting scientist. *
What is the time frame of your potential assistance? *
Can your organization provide any financial assistance to the visiting scientist (travel, housing, subsistance)? *