2021 Michael Bruno Memorial Award Nomination Form

Please read through the application requirements and prepare all of the necessary materials before you begin to fill out the online nomination form.

All marked fields (*) are mandatory. Incomplete applications will not be considered.

Submission deadline: December 1, 2020

NOMINATOR DETAILS

Name of Nominator *

Nominator's Email Address *

Nominator's Mobile Phone Number *

CANDIDATE DETAILS

Name of Candidate *

Candidate's Date of Birth (dd/mm/yyyy) *

Day

Month

Year

Candidate's Email Address *

Candidate's Mobile Phone Number *

Candidate's Academic Affiliation *

Candidate's Field of Research *

PhD Approval Year *

Abbreviated rationale for nominating the candidate (150 words max) *

Describe your relationship to the candidate, including potential conflicts of interest *

PUBLICATIONS

Please list the candidate's three most important publications:

Publication #1 *

PDF of publication #1 *

(indicated in the online form) If one of this publications is a book, one representative chapter from the book will suffice.
More information

Files must be less than 8 MB.
Allowed file types: pdf.

Publication #2 *

PDF of publication #2 *

More information

Files must be less than 8 MB.
Allowed file types: pdf.

Publication #3 *

PDF of publication #3 *

More information

Files must be less than 8 MB.
Allowed file types: pdf.

INTERNATIONAL EXPERTS

Please list international experts in the candidate’s field (name, affiliation and contact information)

International Expert #1: *

International Expert #2: *

International Expert #3:

International Expert #4:

ADDITIONAL INFORMATION

Please list any additional information that may be helpful

DOCUMENT UPLOADS

Upload Candidate's CV *

More information

Files must be less than 2 MB.
Allowed file types: pdf doc docx.

Upload Letter of Recommendation *

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Files must be less than 2 MB.
Allowed file types: pdf doc docx.

Upload Additional Letter of Recommendation - Israeli Faculty *

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Files must be less than 2 MB.
Allowed file types: pdf doc docx.

Israel Institute for Advanced Studies

2021 Michael Bruno Memorial Award Nomination Form

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