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Registration for the Distinguished Personality Award - Ján Bahýl Award

Registration form - Ján Bahýľ Award

Submitted by

Name and surname of the proposer*:

Institution/address*:

Contact email*:

Phone/Mobile:

Nominant

Name and surname of the nominee*:

Date of birth of the nominee*:

Contact email for the nominee*:

Phone/Mobile of the nominee:

Written justification of the nomination*:

Attachments**

Professional structured curriculum vitae of the nominee:

Background of publication activity:

Evidence and/or references of the implementation of the patented solution in practice:

* required items
** the maximum size of all attachments is 25 MB, if you want to include more files in one entry, they must be compressed into one file

 

Verification of correct completion of the form

Write the result of the example:

(x is the sign for multiplication)

Iný obrázok
Overenie pravosti