Shoman Foundation: Application Form

Application Form

First: Information about the candidate

First Name *:

Middle Name *:

Grandfather *:

Last Name *:

Candidate’s quadruple name (in Arabic) :

Place and Date of Birth *:

Nationality *:

Place of Permanent Residence :

Current job :

Work address(Employer)

Phone No. :

Fax No. :

E-mail :

State (Country) :

International code :

Home Address

Phone No.(Home) :

Fax No. :

P.O. Box :

Mobile(if available) :

Address during vacation :

Specific Scientific specialization of the candidate *:

Academic qualifications *:

Degree	Date	University	Subject/Thesis
Bachelor’s Degree
Master’s
PhD

Summary of submitted work :

Prizes and Awards Won by Nominee, and Dates of Their Presentations :

Second: Information about the nominating authority (unnecessary)

Nominating authority (name of authority) :

Address :

Phone No. :

Fax No. :

Mobile(if available) :

E-mail :

Reasons for Nomination *:

The nomination should be accompanied by the following:

(4) copies of the product submitted for the award.
Curriculum vita (3 copies).

Notes:

Please complete the information required accurately to facilitate the Scientific Commission’s work.
Candidates outside Jordan are kindly requested to provide a recent copy of passport.

Nominations will be sent to the following address:

Chairman of the Scientific Commission
Abdul Hameed Shoman Award for Children’s Literature
Abdul Hameed Shoman Foundation
P.O. Box: 940255 Amman 11194
Fax: 00962-6-4633565
00962-6-4659164
Tel.: 00962-6-4659154
00962-6-4633372
00962-6-4633627
e-mail: AHSF@shoman.org.jo - www.shoman.org.

Print The Form:

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