TWAS Membership Nomination 2011 Deadline: 31 March 2011 Certificate of a Candidate for 2011 Election into TWAS Membership Nomination Form (to be typewritten in English) Kindly read the information overleaf prior to completing the form. A candidate must be proposed by a TWAS Fellow or an Associate Fellow. Candidates for TWAS membership cannot also be nominated for TWAS Prizes. The attached nomination form is to be completed in all its parts, and no references should be made to attachments and/or annexes. The form must be signed by two TWAS Fellows or a TWAS Associate Fellows. A complete list of publications should be attached to the completed form. The deadline for receipt of forms is 31 March 2011. Nominations received after this date will be considered in the following year. Completed forms and enquiries should be directed to: Prof. Mohamed H.A. Hassan Executive Director TWAS, the academy of sciences for the developing world via Beirut, 6 34151 Trieste, ITALY Phone: (+39 040) 2240-327 Fax: (+39 040) 2240-7327, 224-559 E-Mail: mhassan@twas.org TWAS Nomination Form 2011 Information 1. Only those scientists who have attained the highest international standard and have made significant contributions to the advancement of science should be nominated as Fellows or Associate Fellows. 2. Scientists from countries with well established and recognized national academies should first be elected into their national academy before being nominated for TWAS membership. 3. Nomination for Fellow is for scientists who work and live in a developing country and who have made contributions to their respective field(s) of science that meet internationally accepted standards of excellence. 4. Nomination for Associate Fellowship is for scientists who work and live in a developed country and who have made contributions to their respective field(s) of science that meet internationally accepted standards of excellence and who, additionally, have distinguished themselves in efforts to promote science in developing countries. 5. According to section IV of the TWAS Statutes the procedure of election of Fellows and Associate Fellows is as follows: • The nomination of a candidate for election into the Fellowship and Associate Fellowship of the Academy shall be made in writing on a certificate signed by at least two Members; • The Council shall appoint Membership Advisory Committees for the purpose of advising the Council on the qualifications of candidates nominated for Membership; • The Council, after reviewing the comments and recommendations made by the Membership Advisory Committees, shall determine the final list of candidates for election to the Membership of the Academy. • The candidates on the final list shall be presented by the President to the General Meeting together with information on their qualifications. NB: The deadline for receipt of nominations is 31 March 2011 TWAS Nomination Form 2011 Please (1) save the completed form under the candidate's name (in the format SURNAME_Initial.doc, e.g. PALIS_Jacob.doc) and send it to the TWAS Secretariat by e-mail (mhassan@twas.org) and (2) fax the first page containing your signature to +39 040 2240-7327, 224559. Candidates for TWAS Membership cannot also be nominated for TWAS Prizes. TWAS Members proposing the candidate NOMINATOR 1: Full Name: Date: Signature: NOMINATOR 2: Full Name: Date: Signature: Membership Details The candidate is nominated for election into the following membership category1: Fellowship (F) Associate Fellow (AF) The candidate should be considered by the TWAS Membership Committee for… (please mark ONE box only!) Agricultural sciences Engineering sciences Structural, cell and molecular biology Earth, astronomy and space sciences Biological systems and organisms Mathematical sciences Medical and health sciences (including neurosciences) Physics Chemical sciences Social and Economic Sciences Candidate's Details Surname Name Current nationality: Previous nationality: Date of birth2: Town and country of birth: Gender: Male or Female? Fax: E-mail: Scientific field: Position / Title: Contact address (institution): Phone: 1 Fellows are scientists who work and live in a developing country and who have made contributions to their respective field(s) of science that meet internationally accepted standards of excellence. Associate Fellowship are scientists who work and live in a developed country and who have made contributions to their respective field(s) of science that meet internationally accepted standards of excellence and who, additionally, have distinguished themselves in efforts to promote science in developing countries. 2 Candidates of age 70 years and above will NOT be considered for nomination. NB: The deadline for receipt of nominations is 31 March 2011 TWAS Nomination Form 2011 Candidate's Details (continued) Degrees held: Professional Appointments (please specify all appointments, including position, period and country): Science academies* the candidate is an elected member of: Professional societies the candidate is a member of: Awards and honours: * Scientists from countries with well established and recognized national academies should first be elected into their national academy before being nominated for TWAS membership. NB: The deadline for receipt of nominations is 31 March 2011 TWAS Nomination Form 2011 Citation of major research accomplishments (up to 50 words): Candidate's Details (continued) Biographical information, including statement of qualifications and principal grounds on which the proposal is made (at least 250 words): NB: The deadline for receipt of nominations is 31 March 2011 TWAS Nomination Form 2011 List of the candidate's 12 major publications (a complete list of publications should also be attached): NB: The deadline for receipt of nominations is 31 March 2011 TWAS Nomination Form 2011 Names, addresses and EMAIL contacts of at least five referees with a wide geographical distribution NB: The deadline for receipt of nominations is 31 March 2011