INTERNATIONAL UNION OF RADIO SCIENCE

UNION RADIO-SCIENTIFIQUE INTERNATIONALE

Rules for URSI Awards

NOMINATION FORM FOR URSI AWARDS

1. Nominator:

Name
Address
Phone
Fax
Email

2. Name of Candidate:

Family name
First name
Birth Date / (dd/mm/yyyy)
Nationality
Gender

Candidate’s present occupation:

Position
Organization
Other details

Candidate’s business address:

Country

Candidate’s home address:

Country

3. Candidate’s education

(Honorary degrees denoted by H, Extend table as needed)

Educational Institution / Location / Degree / Year

4. Proposed citation (not more than thirty words)

5. Candidate’s employmenthistory

Present position first. Limit to one page, extending the table as required.

From
(year) / To
(year) / Name of Employer / Position and Responsibilities

6. Candidate’s professional awards

Honours, Awards, Professional Society Memberships. Extend table as required.

Professional Citation / Citation Body

7. Major professional, government and international committee memberships

Extend table as required.

Professional Citation / Citation Body

8. Candidate’s principal publications, patents etc

Identify the ten most significant contributions. Preferably provide items of sole responsibility, otherwise give joint names with an indication of the candidate’s role.

Title and reference / Comment
1
2
3
4
5
6
7
8
9
10

(A more complete list can be provided in an annex if this is necessary – maximum 5 pages).

9. Prize or medal for which the candidate’s work is particularly relevant

Balthasar van der Pol Gold Medal

John Howard Dellinger Gold Medal

Appleton Prize

Booker Gold Medal

Issac Koga Gold Medal

SantimayBasu Prize

Karl Rawer Gold Medal

10. Arguments in support of the nomination

(Limit to one page, 11pt font or larger)

11. Name and contact details ofat least 5 potential referees

Name
Address
Phone
Fax
Email
Relationship to Candidate, if any
Name
Address
Phone
Fax
Email
Relationship to Candidate, if any
Name
Address
Phone
Fax
Email
Relationship to Candidate, if any
Name
Address
Phone
Fax
Email
Relationship to Candidate, if any
Name
Address
Phone
Fax
Email
Relationship to Candidate, if any
Name
Address
Phone
Fax
Email
Relationship to Candidate, if any
Name
Address
Phone
Fax
Email
Relationship to Candidate, if any

Nomination formPage 1 of 6version 2016-09-27

for the URSI Awards