Application for access to “QCI Connect”

Fill in the fields below to file the DLR access application (Anmeldung Zugang „QCI Connect“). It is completed as a PDF and sent to the email address you give. Fields marked * are required.

Applicant

Academic title

First name *

Last name *

Your email address *

The completed application is sent here.

Citizenship(s)

All citizenships have to be listed, in English.

Company — full name and address

One entry per line. Three lines fit into the form field.

Reason for requesting access

Why you are applying *

If you are unsure, leave this as it is.

Signature

Upload your signature as a PNG or JPEG image — ideally a scan or photo of a signature on white paper, cropped tightly, with a transparent or white background. Leave it empty to sign the printed document by hand. By signing you confirm the terms of use and the data protection rules in their current version, which are shown on the QCI Connect start page.

Signature image

Date *

Thank you