IRMMW-THz Society Kenneth J Button Prize
NOMINATION FORM
Submit this form and any accompanying endorsement letters by email to phs@caltech.edu by
April 1. Complete all questions and observe the word limits. Only one person can be nominated
per form. See guidelines on this web site for eligibility and restrictions.
* Denotes required field. Note that no SPELL checking is done on the form fields. You may
copy/paste your entries from other sources.
1. *CANDIDATE INFORMATION.
Name (First/Given, Middle, Last/Family/Surname):
Email address:
Title (Dr., Prof., Mr., Ms):
Affiliation:
Address line 1:
Address line 2 (if needed):
City:
State or Province:
Country:
Postal Code:
Phone (country code, area code, number):
*HIGHER EDUCATION. List degrees and/or Honorary degrees. Limit five (5). Include the
institution/location, degree, year conferred, and any honors. Start with most recent.
A.
B.
C.
D.
E.
*PRINCIPAL EMPLOYMENT. Include years, name of employer, title, and a one-sentence
description of most recent responsibility. List most recent position first. Limit four (5).
A.
B.
C.
D.
E.
*PRINCIPAL HONORS. Briefly describe the candidate’s highest honors, (5) five maximum.
Include whatever you consider the most significant with respect to this award.
A.
B.
C.
D.
E.
*MOST SIGNIFICANT PUBLICATIONS (ARTICLES AND/OR BOOKS), PROGRAMS, PRODUCTS,
AND PATENTS OR INVENTIONS. Maximum of ten (10) evidences of accomplishment that are
most relevant to this nomination. Include the following: name of item, date published or
announced, name of publication or event, and/or patent number.
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
6. *PROPOSED CITATION. Limit 30 words.
7. *SPECIFIC ACCOMPLISHMENTS ASSOCIATED WITH THIS NOMINATION AND CITATION.
Limited to 5000 characters (approximately 600 words).
8. *ECONOMIC, TECHNICAL OR PROFESSIONAL IMPACT OF CONTRIBUTIONS. This section is
heavily weighted in the committee’s evaluation of the candidate. Limited to 3000 characters
(approximately 400 words).
9. *ENDORSERS. A maximum of three endorsement letters can accompany this nomination.
The letters must be received on or before April 1, and should be addressed to the Awards
Committee Chair and mailed directly to phs@caltech.edu. PLEASE LIMIT THE LETTERS TO ONE
PAGE. The nominator cannot be an endorser. All endorser contact information is required
below. Personal or professional contact information is acceptable.
*A.
Name (First/Given, Middle, Last/Family/Surname):
Email address:
Title (Dr., Prof., Mr., Ms.):
Affiliation:
Address line 1:
Address line 2:
City:
State or Province:
Country:
Postal Code:
Phone (country code, area code, number):
*B.
Name (First/Given, Middle, Last/Family/Surname):
Email address:
Title (Dr., Prof., Mr., Ms.):
Affiliation:
Address line 1:
Address line 2:
City:
State or Province:
Country:
Postal Code:
Phone (country code, area code, number):
*C.
Name (First/Given, Middle, Last/Family/Surname):
Email address:
Title (Dr., Prof., Mr., Ms.):
Affiliation:
Address line 1:
Address line 2:
City:
State or Province:
Country:
Postal Code:
Phone (country code, area code, number):
10. *NOMINATOR INFORMATION.
Name (First/Given, Middle, Last/Family/Surname):
Email address:
Title (Dr., Prof., Mr., Ms.):
Affiliation:
Address line 1:
Address line 2:
City:
State or Province:
Country:
Postal Code:
Phone (country code, area code, number):
11. *RELATIONSHIP TO NOMINEE. Please briefly describe your relationship to the candidate,
how long you have known, or known of, the candidate and whether you have worked with or
for the candidate.
NOTE: The KJB Awards Committee reserves the right to reject any nomination that does not fit
the scope or context of the award. Nominations for the same candidate may be resubmitted in
successive years but all materials must be renewed, including endorser letters.