Fellows Nomination Form

BASIC INFORMATION

Name of Nominator *

Name of Nominator

Name of nominator or representative of constituent society submitting the nomination.

First Name

Last Name

Organisation *

Please select

If others, please state:

Email Address of Nominator *

Contact number of Nominator

e.g. 65891111

Name of Nominee *

Name of Nominee

First Name

Last Name

Email of Nominee *

Contact Number of Nominee

e.g. 85964123

Suggested citation *

In less than 20 words. E.g. “For his fundamental work in developing a method of Poisson approximation”

Link to Nominee's CV or website

If available. Otherwise, please email it to snas_417e@sendtodropbox.com together with your supporting letter. Please name the file using the nominee's name followed by a description. E.g. "Lim Ah Bee CV". Thank you.

http://

Recommendation letter and Supporting Documents

A recommendation letter will be helpful. All supporting documents must be named using the nominee's name followed by a description. E.g. "Lim Ah Bee recommendation letter". Please email your document/s to snas_417e@sendtodropbox.com. Thank you.

*Compulsory

PDPA NOTICE By submitting the nomination form, consent is given to SNAS under the Personal Data Protection Act 2012 to collect, use and disclose your personal data: 1. as provided in this nomination form and accompanying files, or 2. as visual images, photographs and/or videos captured during SNAS events about yourself, the nominee and representatives from your organisation who may be involved, for the purpose of administering the nomination, marketing and promotional activities related to SNAS and the promotion of Science in Singapore or beyond. If you are not agreeable, please refrain from submitting this form.

Fellows Nomination Form

Singapore National Academy of Science