1/4

To: The organizing committee of the Masao Horiba Awards, HORIBA, Ltd.

Application for the 2016 Masao Horiba Awards

(day), (month), 2016

I submit an application as follows to the 2016 Masao Horiba Awards.

Full Name in alphabet / (family name), (middle name) (first name)
Full Name in Chinese characters if applicable
Signature / Nationality
Date of Birth / (day) (month) (year) (age) / Male or Female
Name of Affiliated Organization
Division
Job Title
Postal Address of
Organization
Postal code: / Country:
Tel: / Fax:
E-mail:
1.Brief Resume
(Education, academic degrees with the year conferred, professional experience, past awards with the year received)


2/4

To: The organizing committee of the Masao Horiba Awards, HORIBA, Ltd.

Application for the 2016 Masao Horiba Awards

2. Title of Research Applied for Consideration
3. Abstract
4.Synopsis of Applied Research for Consideration
(Outline, background, main features, and significance of the research, the role played by the applicant.)
Maximum three A4 sheets can be attached.


3/4

To: The organizing committee of the Masao Horiba Awards, HORIBA, Ltd.

Application for the 2016 Masao Horiba Awards

5. Future Perspectives
(Future perspectives and expected social contribution of the applied research and plans for presentation in academic meetings)
6. Other Research Achievements (Maximum One A4 Sheet.)
Please write any other research which the applicant has undertaken in addition to the research to be applied.
Please insert charts or diagrams as required.


4/4

To: The organizing committee of the Masao Horiba Awards, HORIBA, Ltd.

Application for the 2016 Masao Horiba Awards

7. Major publications (list a maximum of ten publications)
- Please select a maximum of three publications from your major publications list that are central to the applied research with a brief explanation of the roles played by the applicant
- Please attach eight copies each of the central publications


1/1

To: The organizing committee of the Masao Horiba Awards, HORIBA, Ltd.

Recommendation Letter to the 2016 Masao Horiba Awards

(day), (month), 2016

＜written by＞

Full Name:
(family name), (middle name) (first name)
/ Relationship to the applicant:
Signature:
Name of Affiliated Organization:
Division:
Job Title:
Location of Organization:
Postal Code:
Tel: / Fax:
E-mail:

* Should be written by director/president of the institution or his/her supervisor

I hereby recommend the person named below for the 2016 Masao Horiba Awards

Full Name: / (family name), (middle name) (first name)
Date of Birth / (day) (month) (year)
Name of Affiliated
Organization
Division
Job Title:
Reasons for Recommendation: (One more A4 sheet can be attached.)