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First Name *

Last Name *

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Country * shortFormSubmission Afghanistan Åland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil Brit/Indian Ocean Terr. Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo The Dem. Republic Of Cook Islands Costa Rica Côte D'Ivore Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Terr. Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Heard/McDonald Isls. Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati Korea (North) Korea (South) Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia Moldova Monaco Mongolia Montserrat Morocco Mozambique Myanmar N. Mariana Isls. Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Norway Oman Pakistan Palau Palestinian Territory Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Samoa San Marino Sao Tome/Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovak Republic Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka St. Helena St. Pierre and Miquelon St. Vincent and Grenadines Sudan Suriname Svalbard/Jan Mayen Isls. Swaziland Switzerland Sweden Syria Taiwan Tajikistan Tanzania Thailand Timor-Leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks/Caicos Isls. Tuvalu Uganda Ukraine United Arab Emirates United Kingdom US Minor Outlying Is. United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S.) Wallis/Futuna Isls. Western Sahara Yemen Zambia Zimbabwe

Department * shortFormSubmission eCommerce / Marketing Engineering Finance General InStore IT Logistics Maintenance None Packaging Production Purchasing Quality Sales Supply Chain Transport / Distribution Warehouse

Level * shortFormSubmission Director Manager Collaborator

Company *

Industry * shortFormSubmission Trade - Food Retail Trade - Non-Food Retail Trade - Wholesale Trade - Food Service Manuf - Metal & non-ferro Manuf - (Petro)Chemical Manuf - Pharma & Cosmetics Manuf - Construction Supplies Manuf - Equipment & Electro Manuf - Automotive & Aeronautics Manuf - Paper & Carton Manuf - Textile & Leather Manuf - Food, Bev. & Cleaning Manuf - Others (furniture, toys, …) Services - Banking & Insurance Services - Hospitality Services - Utilities & Telecom Services - Healthcare Services - Maint., Constr., Others Services - Postal & CEP Services - Transport & Logistics Services - People Transportation Services - IT & Consultancy Services - Manuf. w/o local prod. Public, Gov, Army, Education Extraction, Agricult., Breeding Manuf – Medical Devices & Optical

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