EuChemS Gold Medal Nomination Form

Full name of the nominee*

Prefix First name Last name

Name of the nominator*

Prefix First name Last name

Email of the nominator*

Nominator´s affiliation*

In which capacity is the nominator making this nomination?*

Nomination Letter*

You may submit the nomination letter as an attachment. If so, please write “attachment” in the box below. (max. 1500 characters with spaces)

File

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Max. file size: 100 MB, Max. files: 1.

Support Letter 1

Support letters may also be added, but are not compulsory. Support letters should come from two additional scientists (i.e. not the nominator) that are not working at the same institution as the candidate. Please state the name, email address and affiliation of scientist who wrote the support letter. You may submit the Support Letter 1 as an attachment. If so, please write “attachment” in the box below. (max. 1500 characters with spaces)

File

Drop files here or

Max. file size: 100 MB, Max. files: 1.

Support Letter 2

Support letters may also be added, but are not compulsory. Support letters should come from two additional scientists (i.e. not the nominator) that are not working at the same institution as the candidate. Please state the name, email address and affiliation of scientist who wrote the support letter. You may submit the Support Letter 2 as an attachment. If so, please write “attachment” in the box below. (max. 1500 characters with spaces)

File

Drop files here or

Max. file size: 100 MB, Max. files: 1.

Nominee's CV*

You may submit the CV as an attachment. If so, please write “attachment” in the box below. (max. 7000 characters with spaces)

File

Drop files here or

Max. file size: 100 MB, Max. files: 1.

If you would like to provide any additional information, please use the box below:

(max. 1500 characters with spaces)

By typing your name in the box below, you declare that the information provided in this form is true and accurate*

By clicking agree, you confirm having read the EuChemS privacy statement available online at: https://www.euchems.eu/about-us/privacy-statement/. No changes are possible after you press the submission button, i.e. no re-entry to an incompletely filled questionnaire is allowed. No personal data other than that which is provided will be saved or disclosed.*

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After submitting the nomination, the nominator will receive an email confirmation. Please check your spam folder, and in the event that you do not receive a confirmation email, please contact us at awards[at]euchems.eu

EuChemS Gold Medal Nomination Form

Nomination – EuChemS Gold Medal 2024

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