Details of each partner

Surname:
First Name:
Job title:
Department:
Museum or Organisation:
.
Legal status:
(please attach a copy of the legal statutes, if applicable)
Address:
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Country:
Telephone number:
Fax number:
E-Mail:

If not a museum, specify the field of work:
.
.
If a museum, please fill out:
Museum typology:
Who runs it?
Area it serves:
Audience it serves:
Is it currently accessible to the public?
Annual budget in ECU:
Percentage of items displayed:
Exhibition surface area:
Number of total staff:
Number of qualified staff:
Number of visitors per year:

State the museum collections (main periods, disciplines, geographical areas, etc.):

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.
.
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Specify museums with which you already work regularly:
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Budget related to the partner's participation in the project

EXPENDITUREINCOME
Detailed itemsNational
currency
Sources of incomeNational
currency
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TOTALTOTAL

Bank details of the partner

Name of the bank account holder:
Bank account number:
Name of the bank:
Full address of the bank:
.
.

Date:
Signature of the partner: