Entry Form 2012

António Champalimaud Vision Award Nomination Form 2012
   

Entry form, pdf. Entry form, Word.

Nomination forms must be fully completed and signed by the nominator on page 6.

In addition please include in your entry a bibliography pertaining to the candidate’s work with the five most relevant articles clearly marked (please include up to five publications since 2006)  as well as up to three supporting letters by people not affiliated with the organisations with which the candidate is involved.

Please submit by mail all material typed in English, both on paper and disk/digital form (Microsoft word or adobe.pdf format), to:

Champalimaud Foundation
Champalimaud Centre for the Unknown
Av. Brasilia s/n
1400-038 Lisboa
Portugal

Completed Entries must be received in full by the Foundation no later than December 31st, 2011.

For more information please contact:
T (+1) 617 959 5277 or (+351) 210 480 200
award@fchampalimaud.org