Request Form

Request Form

 

Please, PRINT THIS DOCUMENT, fill it out, sign it and send it, by mail or fax, along with the confidentiality form, to:

Centro de Investigaciones Sociológicas
Departamento de Banco de Datos
C/ Montalbán 8
28014 Madrid
Tel: + 34 91 580 76 17 / 22
Fax: + 34 91 580 76 19

Applicant's personal information
Surname(s):
Name:
Nationality:
University/centre/company:
Post/occupation:
Contact address:
City/Town:
Province:
Post code:
Country:
Telephone:
Alternative telephone:
Fax:
E-mail:
INVOICE ADDRESSED TO:
NIF/CIF/Passport number:

Type of data

Micro-data files

This files are provided in ASCII format. We recommend that you use a statistics program to process this information (SPSS, SAS...). For some studies we can also provide a variable definition file (syntax file) in SPSS.

Code	Title	Date

 

Frequency distribution

For certain studies only (check with the Data Bank Department first)

Code	Title	Date

 

Object of the request

	Research / book
	Documentation
	Thesis
	Projects/plans/campaigns
	Course work
	Means of communication
	Conference / Paper
	Teaching
	Other

Form of payment

	Cash
	Attached cheque to the order of the Centro de Investigaciones Sociológicas
	Bank Transfer to Banco Bilbao Vizcaya Argentaria (BBVA), Account Number: 0182 2370 47 00000 18771, (indicate the sender's full name when making the transfer)
	Payments from abroad: Bank Transfer to Banco Bilbao Vizcaya Argentaria BBVAESMMXXX, Account Number: IBAN ES43 0182 2370 4700 0001 8771, (indicate the sender's full name when making the transfer)

NOTE: Your request will be delivered once we receive the payment receipt (which can be sent by fax).

Type of delivery
	Picked up at the CIS
	By regular mail
	By courier company (paid by addressee)
	By E-mail

The requester knows and accepts the following:

• The requested materials are subject to Copyright in favour of the entities that produced them. Without prejudice to any of the exceptions that may be established under the legislation in effect, this information may not be reproduced or transmitted, totally or partially, in any way or by any means, be it electronic, mechanical or of any other nature. The requester hereby expressly agrees not to use this data for commercial purposes, nor pass it on to any third parties by any means of dissemination, without express and written authorisation from the CIS. In all cases, the requester is aware that the source of the data must be indicated whenever any public use is made of it, in any way.
• In compliance with Constitutional Law 15/1999, 13th December, on Personal Data Protection, requesters are aware that the personal information contained in this application will become part of a computer file, under the responsibility of the CIS, which will be used exclusively for statistical purposes. Furthermore, requesters are aware that they have the right to access, correct, cancel or object to the above-mentioned file.

I AM AWARE OF ALL TERMS AND I AGREE TO THEM: In                     , on                    200

(applicant's signature)