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FNR Award for Outstanding PhD thesis Application Form

FNR Award for Outstanding PhD thesis Application Form

FNR Award for Outstanding PhD thesis Application Form

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Proposer (please fill in only if different from the candidate)<br />

Family name<br />

First Name<br />

Birth family name (if applicable)<br />

Title<br />

Function<br />

Date of Birth<br />

Gender<br />

Nationality<br />

Your connection with the candidate<br />

For Proposers only:<br />

Yes, I have in<strong>for</strong>med the candidate that I am submitting a proposal on his/her behalf <strong>for</strong> the<br />

<strong>Award</strong> <strong>for</strong> <strong>Outstanding</strong> <strong>PhD</strong> Thesis.<br />

AWARD OUTSTANDING PHD - APPLICATION FORM 2 of 7 2/6/2012

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