Handicap International

I am scientist and I support
the "Call by scientists for a mine free Earth"

I have read the text of this appeal by the scientific community and I accept to join with my collegues in signing this document.

Indicate clearly the title or rank under which you wish to appear

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NAME	FIRST NAME

RANK / TITLE

SPECIALITY

ADRESS

ADRESS

ZIP CODE	CITY

NATIONALITY

E-MAIL

In conformity with Article 27 of French law n°78-17 of the 6th January 1978, the information requested is necessary for the use of your signature by our organisation. By contacting the head office of Handicap International, you can request the correction or the suppression of this information, or you can require that it is neither given to nor exchanged with a third party. In this latter case, the information concerning you will be reserved for the exclusive use of Handicap International.