RADBOUD WOMEN FULL PROFESSORS NETWORK

NVH jubilee prize 2017

Registration form

·  Candidates: Female scientists who completed a PhD on or after 01-10-2011 (prolongation clause may apply) and whose primary appointment is at Radboud University or the RadboudUMC. Four prizes will be awarded across several scientific fields: arts/ humanities, natural sciences, social sciences and medical sciences. The prizes will be awarded on 8 March 2017 during the NVH conference ‘Women in the Spotlight’ at LUX in Nijmegen.

·  Regulations and criteria: see the document with regulations attached

·  Submission procedure: Female scientists can nominate themselves or can be nominated by supervisors, dean or colleague(s). Please send the NVH registration form to before the closing date (see below); forms submitted after the closing date and/or any by other means of submission will not be accepted. You will receive a confirmation after submission of the registration form.

·  Closing date for submission: 20 January 2017 at 12 midnight. The four laureates will be informed mid-February 2017.


Personal details

Name candidate:

First name/ first names:

Date of birth:

Place of birth:

Title:

Functie:

Faculty/ Unit/ Institute:

Scientific field (Please mark which one is (the most) applicable)

  Arts/ humanities

  Natural sciences

  Social sciences

  Medical sciences

Year of PhD completed:

Prolongation clause* (applicable in case of long-term sickness absence, pregnancy leave, parental leave, part-time work in combination with care responsibilities): yes/ no**

If yes, please motivate:

E-mail work:

Tel.no. work:

E-mail private:

Tel.no. private:

Signature:


Self nomination: yes/ no**

Name nominator (if applicable):

Title:

Position:

Faculty/ Unit/ Institute:

Handtekening:

*Please see ‘Regulations for Awarding the Radboud Women Professors Network Jubilee Prize’

** Please circle where applicable


Curriculum Vitae

Overview of the various criteria for the assessment:

§  Scientifc output

§  Public and social engagement

§  Important teaching achievements

§  Prizes and grants awarded

§  Relevant work experience(s) abroad

The fields below can be extended, if necessary

Summary of the most important scientific results (maximum of 250 words)

Overview of the five most important publications/ books

(please indicate for each publication: title, author(s), short description of the research, journal, impact factor of the journal (bold), year, volume, pages)
Total overview of scientific publications/ books

(No abstracts or conference papers. Please provide an overview of all references, including title, author(s), journal, impact factor of the journal (bold), year, volume, pages)

Public and social engagement

(within or outside the university, for example (advisory) committees, editorial boards, organizing committee of conferences, valorization)

Most important teaching achievements

Prizes and grants awarded

Relevant work experience(s) abroad

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