CNRS Awards – Nomination 2015

Application form

Deadline: April 17, 2015

Important Information for the Applicant

The nomination file should be submitted electronically. Please note the following: (1) save the nomination file under the nominee's name in the format SURNAME-first name.doc (egDOE-John.doc if the candidate's name is John DOE) and send it to , (2) Since we also need to have your signature on file, please then print out the first page of the nomination form, sign it and fax it to:01-822639

All information required for evaluation must be included in this form – except for the candidate’s complete list of publications which should be attached to the nomination form as separate file. Any other material will not be taken into consideration.

- Candidates for a CNRS Prize must be scientists who have been working and living in Lebanon for at least fiveyears immediately prior to their nomination.

- Scientists who received a CNRS award over the past five years are not eligible to apply for the 2015 awards.

Please tick the scientific domain this nomination is for (only one):
Agricultural and Environmental Sciences: / Medical, biological and public health Sciences:
Basic Sciences and Engineering: / Human and Social Sciences:
Please tick the scientific field this nomination is for (only one):
Mathematics. / Sustainable management of water resources.
Biophysical & Biomedical Science and Engineering. / Sociological research on regions in Lebanon under societal, demographic and security pressures & stresses
Cancer: Pathology, diagnosis and treatment. / Sociological, psychological and knowledge research on woman and youth.
Nutritional & metabolic diseases, including those of genetic origin. / Research on archeology and heritage in Lebanon.
Food security and safety.
Nominee
SURNAME: / NAME:
Position/Title: / Date of birth: / Town and country of birth:
Address (Institution): / Phone:
Fax:
E-mail:
Nationality: / Gender: Male Female
Signature: / Date:
Highlight of nominee’s contribution (citation) (20-25 words highlighting the nominee's scientific achievement – please see footnote[1])
Note that CNRS Prizes are given in recognition of a single outstanding contribution to scientific knowledge
Supporting statement (unlimited space – please see footnote[2])
Note that CNRS Prizes are given in recognition of a single outstanding contribution to scientific knowledge

Nominee's biographical information

Biographical sketch of the nominee (unlimited space)
Please provide the nominee’s biography in narrative style
Degrees obtained / Date obtained / Awarding institution
Professional appointments / From - to / Employing institution
Membership in academies and societies
Awards and honours
List of 10 (or less) most significant publicationsdirectly related to the nominee’s single outstanding contribution (please attach the first page - hard copy - of each publication listed below)

Referees

Please provide the contact details (especially the e-mail address) of five referees, whom we can contact regarding the nominee’s work:
Please note that:
- The nominator cannot also act as a referee
- If fewer than three meaningful referee reports have been received by the deadline set by CNRS, the CNRS Administration shall return the nomination to the nominee and consequently will be deleted from the selection process
Surname / Name / e-mail address / Postal address
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[1] Examples of citations which will be engraved on the plaque are:

“For his/her fundamental contribution to the understanding of how infectious agents trigger and maintain auto-immune diseases.”

“For his/her contribution to our understanding of the electronic and magnetic properties of strongly correlated electronic materials based on his/her in-depth experimental and theoretical investigations.”

[2] Supporting statements should explain carefully the work performed, its significance and justification of its outstanding nature.