Factory chimney enthusiast's Form

 
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Fill in your family name
Fill in your surname(s)
The name of the association, organisation or institute you are representing (if any)
Your e-mail or the e-mail of your association
First address line (building, Street, nr, etc)
Second address line (Street, nr,, hamlet, etc)
Post code, zip code
Select the country where you are living
Give the mane of the site you are describing (for example the name of the (former) factory
Country where the chimney is situated (this is not necessary the country where you are living in)
Give or describe the location of the heritage site: at least exact address, if possible geolocation or GPS
Describe the actions you have launched, what you achieved, current projects related to this/these chimney(s), etc...
Add here at least one good photo (max 2 MB) - additional photos in lower resolution can be uploaded in the next field
Files must be less than 2 MB.
Allowed file types: gif jpg png bmp tif.
Add here additional photos in lower resolution - max 800 KB each photo. Max 5 photos are allowed Allowed formats: .gif, .jpeg, .png, .bmp .tiff not allowed
Add here additional documents, reports etc... concerning the chimney. max 800 KB per document. Accepted formats are: .doc, .docx, , .txt, .rtf, .odf, .pdf, .ppt, .pptx, .xls, .xlsx If the document(s) you want to add are to heavy: contact us by mail
I would like to join the project, become partner (Yes/No)