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Surname*
Name*
Name of the company*
Position*
Zip code*
City*
Adress*
Phone*
Fax
E-mail *
Industry, Sphere of activity*	Agriculture Veterinary science Geology Mineral resource industry Criminalistics Laboratory medicine Light industry Engineering industry Metallurgy industry Science and education Food industry Building materials production Sanitary-and-epidemiological services Standardization and metrology Glass industry Gas-and-oil producing industry Pharmaceutical industry Chemical industry Pulp-and-paper industry Ecology Jewellery
Other (please specify)
Your Post composition*	Head of Enterprise Head of Department Specialist
Your functions at Enterprise*	Management Service Production/Technical process Purchases and supply Sale Advertising, marketing
Other (please specify)
Size of Enterprise (Amount of working at Enterprise)*	Less than 10 10-50 51-100 101-200 201-500 501-1000 More than 1000
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Ministry of Health of Ukraine
Ministry of Industrial Policy of Ukraine
Ministry of Education and Science of Ukraine
Ministry of Fuel and Energy of Ukraine
Ministry of Agrarian Policy of Ukraine
Ministry of Coal Industry of Ukraine
Ministry for Environmental Protection of Ukraine
Ministry of Ukraine of Emergencies and Affairs of Population Protection from the Consequences of Chornobyl Catastrophe
Ministry of Internal Affairs of Ukraine
Ministry of Defense of Ukraine
Committee on Public Health
State Committee of Ukraine for technical regulation and consumer policy
National Accreditation Agency of Ukraine
Academy of Medical Sciences of Ukraine