TWAS Young Affiliates Nomination Form 2019
Every year the five TWAS Regional Partners each select up to five scientists to be Young Affiliates for a period of five years. During their tenure, Affiliates are invited to participate in TWAS general meetings and conferences as well as provide feedback to TWAS on how the Academy can respond to the needs of young scientists in developing countries. They are encouraged to provide information about TWAS programmes to their students and colleagues; are encouraged to seek out and nominate excellent scientists from developing countries, especially science-and technology-lagging countries, for TWAS awards and seek out excellent scientists from science-and technology-lagging countries and recommend their nomination for TWAS membership (via a full member of the Academy). The idea of the Young Affiliateship is to give opportunities to young scientists who currently do not have them because they are based in Africa or elsewhere in the developing world.

To be eligible, the nominated scientists must have PhD, be aged 40 or less on 1st January of the year in which they are selected, living and working in a developing country for at least the past three years and have an excellent track record of at least 10 international publications in peer reviewed journals.

Nominations are invited from TWAS and AAS fellows, Members of National Academies and fellows, Members of Young Academies of Science in the region, Research Institutions, Research Councils and Universities in the region. The nomination of women is encouraged.

Selection of the suitable candidates will be based on the recommendations of a Selection Committee comprising TWAS fellows in sub-Saharan Africa.

The completed form should be submitted before or on 31 July 2019, Late submissions/incomplete nominations will not be accepted. All nominations must be submitted online using this form and the supporting documents must be forwarded to thato@assaf.org.za. NB: Nominations without requested documents will not be considered.

NOMINEE'S DETAILS
Surname *
Your answer
Name *
Your answer
Title *
Gender *
Date of birth *
MM
/
DD
/
YYYY
Nationality *
Your answer
Home Institution: Name *
Your answer
Home Institution: Telephone *
Your answer
Home Institution address *
Your answer
Nominee's Contact Number *
Your answer
Nominee's Email Address *
Your answer
ACADEMIC BACKGROUND
Start with most recent
Degree 1 *
Name, Year awarded, Field / Discipline, University, Country
Your answer
Degree 2
Name, Year awarded, Field / Discipline, University, Country
Your answer
Degree 3
Name, Year awarded, Field / Discipline, University, Country
Your answer
Awards and Achievements *
Your answer
HOME INSTITUTION / ORGANIZATION
Information about nominee's affiliation. This is important for showcasing current involvement besides conducting research.
Name of current institution *
Your answer
Institution: Physical address *
Your answer
Institution: Telephone *
Your answer
Employment History
Name of employer 1, Position, From-To, Field of activity, Tasks and responsibilities (maximum 200 words)
Your answer
Name of employer 2, Position, From-To, Field of activity, Tasks and responsibilities (maximum 200 words)
Your answer
Name of employer 3, Position, From-To, Field of activity, Tasks and responsibilities (maximum 200 words)
Your answer
Candidate’s Field of Study and Research *
Required
Citation (provide a brief statement 20 – 30 words on the candidate’s achievements that merits him/her for this nomination) *
Your answer
Biographical sketch of the candidate ( in addition, a complete Curriculum Vitae should be attached as a separate file) (250 words maximum) *
Your answer
Write-up on the candidate’s suitability for the Affiliateship (350 words maximum) *
Your answer
List of the candidate’s 10 most significant publications: *
Your answer
NOMINATOR' DETAILS
Strictly required.
Name *
Your answer
Surname *
Your answer
Email address and Telephone number *
Your answer
Institution *
Your answer
Title and Position *
Your answer
REFERENCES
Please provide the names and addresses of three referees in support of your nomination, and attach a letter of recommendation from one of your referees to your nomination form.
Referee 1: Name, title, position, contact details (telephone, email) *
Your answer
Referee 2: Name, title, position, contact details (telephone, email) *
Your answer
Referee 3: Name, title, position, contact details (telephone, email) *
Your answer
APPLICANT’S ACCEPTANCE OF CONDITIONS GOVERNING THE AFFILIATESHIP
I accept the terms and conditions governing this activity and I confirm that to the best of my knowledge the information above is true and correct. *
SUPPORTING DOCUMENTATION
Important: Please ensure that ALL relevant enclosures are included with the completed nomination form.
Please only submit the material requested to thato@assaf.org.za; do not send any other material. When submitting the attachments, the subject of the email must quote the surname of the nominee e.g Morokong_TWAS YA 2019
Checklist: Ensure that the following supporting documents are forwarded to thato@assaf.org.za immediately after submitting your nomination. *
Required
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service