Get in touch

Registration form

Please fill out this form and agree with the submission terms:

Please fill in all required fields and check the boxes before submitting your information.

Affillation
  • Afghanistan
  • Albania
  • Algeria
  • American Samoa
  • Andorra
  • Angola
  • Anguilla
  • Antigua and Barbuda
  • Argentina
  • Armenia
  • Australia
  • Azerbaijan
  • Bahamas
  • Bahrain
  • Bangladesh
  • Barbados
  • Belarus
  • Belgium
  • Belize
  • Benin
  • Bhutan
  • Bolivia, Plurinational State of
  • Brazil
  • Brunei Darussalam
  • Bosnia and Herzegovina
  • Botswana
  • Bulgaria
  • Burkina Faso
  • Burundi
  • Cabo Verde
  • Cambodia
  • Cameroon
  • Canada
  • Central African Republic
  • Chad
  • Chile
  • China
  • Colombia
  • Comoros
  • Congo
  • Congo, The Democratic Republic of the
  • Côte d'Ivoire
  • Croatia
  • Cuba
  • Cyprus
  • Czechia
  • Denmark
  • Djibouti
  • Dominica
  • Dominican Republic
  • Ecuador
  • Egypt
  • El Salvador
  • Eritrea
  • Estonia
  • Eswatini
  • Ethiopia
  • Equatorial Guinea
  • Finland
  • Fiji
  • France
  • Gabon
  • Gambia
  • Georgia
  • Germany
  • Georgia
  • Ghana
  • Greece
  • Grenada
  • Guatemala
  • Guinea
  • Guinea-Bissau
  • Guyana
  • Haiti
  • Holy See (Vatican City State)
  • Honduras
  • Hungary
  • Iceland
  • India
  • Indonesia
  • Iran, Islamic Republic of
  • Iraq
  • Ireland
  • Israel
  • Italy
  • Jamaica
  • Japan
  • Jordan
  • Kazakhstan
  • Kenya
  • Kiribati
  • Korea, Republic of
  • Korea, Democratic People's Republic of
  • Kuwait
  • Kyrgyzstan
  • Lao People's Democratic Republic
  • Latvia
  • Lebanon
  • Lesotho
  • Liberia
  • Libya
  • Liechtenstein
  • Lithuania
  • Luxembourg
  • Madagascar
  • Malawi
  • Malaysia
  • Mali
  • Maldives
  • Malta
  • Marshall Islands
  • Mauritania
  • Mauritius
  • Mexico
  • Micronesia, Federated States of
  • Moldova, Republic of
  • Monaco
  • Mongolia
  • Montenegro
  • Morocco
  • Mozambique
  • Myanmar
  • Namibia
  • Nauru
  • North Macedonia
  • Nepal
  • Netherlands
  • New Zealand
  • Nicaragua
  • Niger
  • Nigeria
  • Norway
  • Oman
  • Pakistan
  • Palau
  • Panama
  • Papua New Guinea
  • Paraguay
  • Peru
  • Philippines
  • Poland
  • Portugal
  • Qatar
  • Romania
  • Russian Federation
  • Rwanda
  • Samoa
  • Saint Kitts and Nevis
  • Saint Lucia
  • Saint Vincent and the Grenadines
  • San Marino
  • Sao Tome and Principe
  • Saudi Arabia
  • Senegal
  • Serbia
  • Seychelles
  • Sierra Leone
  • Singapore
  • Slovakia
  • Slovenia
  • Solomon Islands
  • Somalia
  • South Africa
  • South Sudan
  • Spain
  • Sri Lanka
  • Sudan
  • Suriname
  • Sweden
  • Switzerland
  • Syrian Arab Republic
  • Tajikistan
  • Tanzania, United Republic of
  • Thailand
  • Timor-Leste
  • Togo
  • Trinidad and Tobago
  • Tunisia
  • Turkmenistan
  • Turkey
  • Tuvalu
  • Uganda
  • Ukraine
  • United Arab Emirates
  • United Kingdom
  • United States
  • Uruguay
  • Uzbekistan
  • Vanuatu
  • Venezuela, Bolivarian Republic of
  • Viet Nam
  • Yemen
  • Zambia
  • Zimbabwe
Contact Information
Opportunity information

Detailed Information of the Opportunity *

    Maximum 3 files. 3 MB limit.

    Allowed types: gif, jpg, png, bmp, eps, tif, pict, psd, out, rtf, html, odf, pdf, doc, doox, ppt, pptx, xls, xlsx, ×ml, avi, mov, mp3, ogg, wav, dmg, jar, rar, sit, svg, zip.

    Submission Terms

    Please agree to the following to complete this application form.

    1. I represent and warrant that I have the authority to disclose this information to Astellas.
    2. I represent and warrant that use of the provided information will not infringe the intellectual property rights of any third party.
    3. I acknowledge and agree that Astellas will not treat the information as confidential or proprietary, and thus will not be restricted from using such information or disclosing such information to third parties.
    4. I acknowledge and agree that there is no guarantee that Astellas will pursue an opportunity with me, or that Astellas will reply to my submission. Any decision to pursue an opportunity with me shall be made by Astellas in its sole discretion.
    5. I acknowledge that I have read and agree to Astellas' Privacy Notice at https://www.astellas.com/en/privacy-notice.

    Agree

    Send Complete

    Thank you for your application. We will review the information in your application form and consider our partnering opportunities. Please note that we will only be replying to applicants who we feel there is a potential for partnership. This will take six weeks.