Welcome to Shoman Foundation
Arabic
Young Arab Award

Application for Nomination to the Award

  First: Information about the Nominee
  First Name *:
  Middle Name *:
  Grandfather *:
  Last Name *:
  Place and Date of Birth *:
  Nationality *:
  Place of Permanent Residence :
  Current Employer :
  Academic Rank *: Professor Associate Professor
Assistant Professor Teacher Other
 
  Employment Address
  University/Scientific Institution : *
  College : *
  Department : *
  Phone No. :
  Fax No. :
  E-mail :
  Home Info. :
  Home Address :
  Phone No. :
  Fax No. :
  Address while on vacation :
  Nominee’s specific specialization : *
  Academic qualifications *:  
Degree Date University Subject/Thesis
Bachelor’s Degree
Master’s
PhD
  Award for which nominee is competing *:
  Summary of submitted work :
Work Number of Contributions
Published research  
Research submitted to conferences, for a and specialized workshops  
Patents  
Books published  
Books reviewed  
  Summary of Services to the Community and Educational Institutions :
  Prizes and Awards Won by Nominee, and Dates of Their Presentations :
  Second: Information about Nominating Parties
  First Nominating Professor :
  Name *:  
  Address :
  Phone No. :
  Fax No. :
  E-mail :
  signature :
  Second nominating professor :
  Name *:  
  Address :
  Phone No. :
  Fax No. :
  E-mail :
  signature :
  Reasons for Nomination *:
 

To be attached with the nomination:

  • Three copies of the nominee’s scientific work
  • Official documents indicating birthday (birth certificate or passport)
  • Personal biography
  • List of published or completed works
  • Any other documents in support of nomination

Notes:

  • Kindly, fill out the required information completely so as to simplify the task of the Committee.
  • Nominees from outside Jordan are kindly requested to attach a recent photocopy of their passports.
Print The Form:
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