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Kuwait Prize 2014 Nomination Form English

This document contains a Kuwait Prize nomination form. It requests background information about the nominee such as name, birthdate, nationality, address, qualifications, academic honors and experience. It also requests a list of the nominee's scientific publications in refereed journals and books from the past 20 years to be included in the nomination submission. The form requires the nominee to declare the originality of their research and take responsibility if that commitment is breached.

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SaberElArem
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54 views7 pages

Kuwait Prize 2014 Nomination Form English

This document contains a Kuwait Prize nomination form. It requests background information about the nominee such as name, birthdate, nationality, address, qualifications, academic honors and experience. It also requests a list of the nominee's scientific publications in refereed journals and books from the past 20 years to be included in the nomination submission. The form requires the nominee to declare the originality of their research and take responsibility if that commitment is breached.

Uploaded by

SaberElArem
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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KUWAIT PRIZE NOMINATION FORM

Declaration and Affidavit


I Click here to enter text. declare and acknowledge of the originality of my nominated scientific
research outcomes and take the full responsibilities in case of breaching this commitment.

(A)

Background Data :

(1)

Field of Award

(2)

Name of Nominee

Click here to enter text.

(3)

Year and Place of


Birth :

Click here to enter text.

(4)

Present
Nationality :

Click here to enter text. Past Nationality : Click here to


enter text.

Proof of Arab Origin :

(6)

Address :

Click here to enter text.

(7)

E-mail Address :

Click here to enter text.

(8)

Telephone
Numbers :

1- Work Click here to enter text.

(5)

Choose an item.

Valid Passport
Birth Certificate in an Arabic country

2- Fax: Click here to enter text.


3- Mobile:Click here to enter text.
4- Home:Click here to enter text.

Note : KFAS requires that winners of Kuwait Prize present proof of their Arabic origin either an
Arabic birth certificate or a valid Arabic passport to visit Kuwait and attend the Prize
ceremony.
(1)

(9)

Qualifications (Bachelor-Master-PhD):
Field

Year

Instituti
on

Degree

Click here to enter text.

Click here
to enter
text.

Click here to
enter text.

Click here to enter text.

(2)

(10) Academic Honors, Grants and Awards (Prize Name


-Grantor- Year)

Click here to enter text.

(3)

(11)
Academic and Administrative experience starting with current
position :

Job Title

Organization/Company Name

From

To

Click here to enter text.

Click here to enter text.

Click here to
enter text.

Click here
to enter
text.

(4)

(B) Scientific Production:


Journal Publications and books Published during the past 20 years
Section (1)
Publications in refereed journals (For papers that are accepted for publications and have not
been published yet, please attach the acceptance letter).
Please list the publications with the name of the author(s), title, journal, and year of publication.
When attaching the publications number them so that they match the list.

Click here to enter text.

(5)

(B) Scientific Production:


Section (2)
Books: Please list the book with the name of authors, editors, translators, the title, the year
of publication, and the publisher. When attaching the books number them so that they match
the list.

Click here to enter text.

(6)

(7)

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