Test_DB_Input

Please fill in the following:

* Required field

Title
First Name*
Middle Initials
Last Name*
email*
Gender*
Country*	Country which you represent at the LUDI COST action, not your nationality.
Role in the Network*	Role in the Network* Action Chair Action Vice-chair WG Leader WG Vice--leader WG-member Short Term Scientific Missions Coordinator Dissemination Manager Networking Manager Website Manager COST Policies Coordinator Advisory Board Member Management Committee Member Management Committee Substitute Core Group Member Delegate by the Grant Holder Institution Invited Expert
Working Groups*
Picture*	Please upload a profile picture (1mb limit)
Personal website, blog or social media link
Ph.D*
Scientific Area	Only complete if PhD : Yes
Year of PhD Award	Only complete if PhD : Yes
Early Stage Researcher*	According to COST, an Early Stage Researcher (ESR) is a researcher in the start phase of his/her career with at least the PhD degree and up to 8 years of experience after the PhD. Professionals that do not hold a PhD degree, who are active in the field of play for children with disabilities for up to 8 years, even if not directly involved in research activities, are also considered Early Stage Researchers.
Sector*
Name of organisation*
Web Address of the Organisation	To be listed as a Research Affiliate at the LUDI website.
Organisation Description	Short text describing the organization in relation to the LUDI network (< 100) To appear in the LUDI website, as a description of the Research Affiliate organisation.
Area of Work*	Please describe your area of work (<200 words) in relation to the theme “Play for children with disabilities”. E.g.: Rehabilitation robotics, namely using robots to enable children with disabilities to participate in play and academic activities, as well as to assess children’s cognitive skills; Occupational therapist, namely promoting function through play activities; Developmental psychologist, namely addressing the importance of play in child development; Education, working with children with disabilities.
Expertise Contributions*	How can your expertise contribute to the scientific area of “Play for children with disabilities”? (< 200 words) When answering this, please take into consideration that the LUDI network focuses/promotes play for the sake of play, rather than play with mainly therapeutic or educational goals.
Network Affiliations	We’re taking this opportunity to gather information necessary for the network, even if outside the scope of the members’ profile. Please answer the following questions: 1. Please list industries, particularly in your country, connected to the field of play for children (with or without disabilities) 2. Please list persons/institutions, particularly in your country, that you think could contribute to the LUDI network, indicating also their activity sector (law, research, clinics, policy, enterprise, ...) and contacts
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