Full name *

ID/Student/Employer/Passport Card Number *

Postal address*

Mobile/App/Phone number *

Email *

Name employer or institution

Your position in the institution

Address (institution)

Phone (institution)

I(we) would like to request climatologcal/hydrological/hydraulic data/water quality data
from your institution.

I(we) will use this data for the purpose of*
Education (development of course material)Project work/assignments (only for students and lecturers)Student thesis research (only for students and lecturers)Research work (only for educational institutes and students/lecturers)Research work (only for governmental, semi governmental and private institutions)Engineering projects (only for governmental, semi governmental and private institutions)Other......

I(we) will use this data for the following purposes (explain in detail and/or attached the project proposal)

In case you have a project proposal, upload this file also
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Data resources

Note: if the requested information is the same for all stations, you only have to sent one application form. In case you want to request information of more than one station with different information’s, you will need to sent several requests.

Station name
Pikin Pada 1APikin Pada 1BPikin Rio 2APikin Rio 2BSuriname River below confluence of Gran Rio and Pikin Rio 3ASuriname River below confluence of Gran Rio and Pikin Rio 3BGran Rio 4AGran Rio 4BBrokopondo lake West 5ABrokopondo lake South 5BBrokopondo Lake East 5CBrokopondo Lake North 5DKlaaskreek 6AKlaaskreek 6BDomburg 7ADomburg 7BLeonsberg 8ALeonsberg 8B

Hydrologicalvariable and type of data
Temperature pHConductivityDissolved oxygenTurbidityTotal suspended solids (TSS)Secchi depthApparent colorAlkalinityHardnessPhosphateNitrateAmmoniaChlorideIronAluminaMercury

Additional Information
Specify anything else required to fulfill this data request.

I (we) agree not to distribute this data to other persons/institutionsI (we) agree to sent your institution a digital or hardcopy of the produced reports/analysis of this data when finished.