1. Title of Project :
2. Principle Investigator :
3. Institute :
Department :
Mail address :
Phone :_______________ Fax :_______________E-mail :______________
3. Participants :
4. Scientific Objective :
5. Methodology and Approach :
6. Additional Remarks :
7. Communicated by BALTEX Science Steering Group member
Name :______________________________________Date :________
Signature :
8. Registered at BALTEX Secretariat
Date :_________Signature: