姓（英文）*
名（英文）*
職稱（中文）*
職務*-- 請選擇 --學術研究員會計師行政管理分析師/研究員助理律師銀行家生物資訊學家生物學家品牌經理市場開發與技術授權執行長/技術長/營運長/資安長首席智權顧問臨床營運臨床試驗專案管理臨床研究科學家市場競爭情報分析顧問合約專家統籌管理專員學院院長/中心主任部門主管協理/總監新藥開發科學家專利程序專員專利程序經理編輯工程師創辦人創新長智權事務長技術授權部門主管學術研發長資訊經理人機構領導人發明人智權顧問IT經理法律事務所合夥人講師法律顧問圖書館員技術授權經理人經理市場分析師行銷經理人醫護人員藥物化學研究員其他負責人法務專員合夥人專利管理員專利代理人專利師專利訴訟律師（事務所）專利申請律師（事務所）專利工程師專利審查員專利研究分析員藥理學家政策制定/決策者產品組合與策略經理總裁/副總裁公共關係/媒體從業人員產品開發人員產品規劃人員教授專案經理校政/行政首長出版商採購人員醫療法規專業人員研究管理人員研發人員研究科學家業務供應及生產管理產業技術標準經理人學生技正技轉經理人商標代理人商標律師培訓專家創投家大學校長
工作Email*
連絡電話*
機構/公司 （英文）*
機構類型*-- 請選擇 --學術研究太空與國防農業汽車業生物科技/生命科學化學建築工程消費產品/服務電商/網路/運算工程財務/銀行/會計/創投食品業政府機關/政府法人單位醫療器材醫療服務資訊仲介服務保險業智權顧問服務法律服務製造業媒體/出版非營利機構石油/天然氣/消耗性燃料其他專利局製藥個體戶專業服務房地產/房仲社團法人/公協會/非政府機構科技業電訊服務業紡織/服飾/奢侈品旅遊/休閒/娛樂公用事業
縣市*
國家/地區*-- Please Select --AfghanistanAland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia, Plurinational State ofBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, the Democratic Republic of theCook IslandsCosta RicaCote d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, the former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldova, Republic ofMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalestinian Territory, OccupiedPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwanTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUS Virgin IslandsUzbekistanVanuatuVenezuela, Bolivarian Republic ofViet NamVirgin Islands, BritishWallis and FutunaWestern SaharaYemenZambiaZimbabwe
我願意接收科睿唯安發送的電子郵件資訊
The name of your form you are creating.
SBU of Lead-- Please Select --CompuMarkIP and StandardsIP ManagementLife SciencesMarkMonitorScientific and Academic Research
Primary Product-- Please Select --AntiFraudAntiPiracyAuthor ConnectBrand ProtectionConnected IP PaymentsConverisCortellisCustom DataDerwentDiscontinued MMDomain MgmtEndNoteInCites PlatformIntegrity / Drug Research AdvisorIP ServicesLife Sciences ServicesMetaCore and Systems BiologyNewportOnlineOther CompuMarkOther Life SciencesPublisher Hub OtherPublonsSaegisScholarOneScientific and Academic Research ServicesSearchTechstreetThe IP Management SystemTM VisionWatchWeb of Science Platform
Sub Primary Products-- Please Select --AbstractsAgro Patent Fast AlertAntiFraudAntiPiracyAuthor ConnectBiomarkersBioWorldBioWorld MedTechBioWorld ScienceBrand ProtectionClinical and RegulatoryCMR InstituteConverisCopyright/TitleCortellisCortellis Clinical Trials IntelligenceCortellis CMC IntelligenceCortellis Competitive IntelligenceCortellis Deals IntelligenceCortellis InformaticsCortellis Regulatory IntelligenceCustom DataCustom IP ApplicationsDerwent APIDerwent Data AnalyzerDerwent Data FeedDerwent Drug FileDerwent InnovationDerwent Patents Citation IndexDerwent World Drug AlertDerwent World Patents IndexDiscovery and TransnationalDomain MgmtDrug Research AdvisorDrugs of the FutureDrugs of TodayEndNoteEssential Science IndicatorsFile Histories and Document ServicesGeneseqIncidence and Prevalence DatabaseInCitesInCites Benchmarking & AnalyticsIntegrityIP Administrative ServicesIP PaymentsIP TransactionalJournal Citation ReportsKey Pathway AdvisorKopernioLife Sciences ServicesManuscriptsMetaBaseMetaCoreMetaDrugNewportOnlineOther CompuMarkPatent Analytics ServicesPatent Licensing ServicesPatent Preparation and Prosecution ServicesPatent Search ServicesPatent Translation ServicesPortfolio and LicenseProceedingsPublisher ReportPublonsPublons Reviewer ConnectPublons Reviewer Recognition ServicePublons Transparent Peer ReviewRoyalties Life SciencesSaegisScientific and Academic Research ServicesSearchTechstreetThe IP Management SystemTM VisionTMgo365Virtual IP OfficeWatchWeb of Science BackfileWeb of Science Citation ConnectionWeb of Science Core CollectionWeb of Science Regional Citation Indexes
Lead Source - Most Recent-- Please Select --Customer ReferralDirect MailEmailEmail - 3rd PartyEvent - 3rd PartyEvent - HostedPaid - Digital AdvertisingPaid - FacebookPaid - LinkedInPaid - Print AdvertisingPaid - SearchPaid - TwitterPaid - WeChatPaid - YouTubePublic RelationsPurchased ListSales - Cold callingSales - Cross/up-sellSales - External referralSales - Inbound callSales - Internal referralSales - Target listSocial - BlogSocial - FacebookSocial - LinkedInSocial - TwitterSocial - WeChatSocial - YouTubeTelequalificationTrainingWeb FormWebinar - HostedWebinar - SponsoredWebinar - Sponsored CA Speaker
To find this, go into SFDC and go to the Campaign, copy and paste the 15-digit ID from the Address Bar. e.g. If address bar is https://na5.salesforce.com/70170000000IXom, insert ONLY 70170000000IXom.
To which campaign do you want this lead attached? Please insert the EXACT campaign name.
Last Follow Up-- Please Select --Follow Up RequiredNo Follow Up Required
Lead Routing-- Please Select --AssignEndNoteIP Services SalesMarketingPatents SalesPublisher/AssociationSalesTechstreetTrademarks SalesTraining
Lead Status-- Please Select --NewAccepted/In ProgressConverted - ContactConverted - OpportunityRejected/No Potential
Marketing Lead Status-- Please Select --MCLMQLSGLSALConverted ContactConverted OpportunityRejected/No Potential
Full name of asset for MailMerge
Example: Email Name
utm_medium-- Please Select --affiliateemailownedpaidsocial
utm_source-- Please Select --adwordsadwords_display blogeloquafacebooklinkedinlinkedin_inmailmagazineowned_displayquorasfdctrade_publicationtwitteryoutube
