Please enable JavaScript in your browser to complete this form.Trade name *It will be shown in the websiteCorporate name *Corporate nameLogo of the company / entity * Click or drag a file to this area to upload. It will be shown in the websiteFoundation year *It will be shown in the websiteTax domicile *Writte the full addressCIF / VAT *Phone *Contact email *Website *Mission of the company / entity *Up to 50 wordsDescription of the company / entity * Visual Text about 100 wordsActivity of the company / entity in general, and specifically in the health sector in Galicia *Visual Text about 100 wordsProducts / servicesVisual Text Identify your company / entity in one of the following value chainsHealthcareQuality of lifeKnowledgeStructureDifferential value of the company / entity in its sectorMain geographic area of activity *Presence in other countriesAnnual turnover of your activity in the health sector in Galicia (average of the last thee years) *Number of employees *PatentsVisual Text Interest in the health field *up to 50 wordsInterest in being part of the CSG *up to 50 wordsOther data of interest (milestone, prizes, etc)Visual Text Linkedin linkTwitter linkFacebook linkInstagram linkRepresentatives dataLegal representative *FirstLastPosition in the company *Phone *Email *Contact person for general information *FirstLastPosition in the company *Phone *Email *Contact person for the dissemination of CSG ́s activities *FirstLastPosition in the company *Phone *Email * Patient associations (4) - 250€ Micro Enterprise (<10pax/2M€) (18) - 500€ Small Enterprise (<50px/<10M€) (21) - 1.000€ Medium Enterprise (<250pax/<50M€) (20) - 1.250€ Big Enterprise (>250px/>50M€) (19) - 1.500€ Quotas without VAT Confirmation *I confirm...I confirm that I have read, understand and accept the Rules of Procedure and the Cluster Saúde de Galicia Statutes in its consolidated version as of December 16, 2021. The agreements for the admission of associates will be made by the Board of Directors and will be ratified by the General Assembly, once the request has been received. The personal data collected from this form will be subject to automated processing and incorporated into the corresponding files owned by the Cluster Saúde de Galicia for internal use and its use in publications and other external communications. These data will only be used for the purposes expressly provided and by duly authorized personnel, in accordance with the provisions of the General Regulation on data protection. En ningún caso, los datos mencionados anteriormente estarán sujetos a tratamiento o cesión a terceros, si no es con el consentimiento inequívoco de la parte In no case, the data mentioned above will be subject to treatment or transfer to third parties, if it is not with the unequivocal consent of the affected party. . You can consult the privacy policy in the following link. You can, at any time, exercise the rights of access, rectification, cancellation and opposition in the manner regulated by law. Custom Captcha * = Send