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2011 Manuel Velasco Suárez Award
 
     
 

The 2011 Manuel Velasco Suárez Award for Excellence in Bioethics Nomination Form

Before completing this nomination form, please be sure that you have read and understand the award and project proposal guidelines. Please ensure you complete all the required fields in your application.

Instructions: Please fill in all the requested information on the nomination form and attach: letter of nomination signed and submitted by the nominator, who may be the nominee, a professor, scholar, researcher, or an official representative of an institution that is involved in the study of bioethics (two-page limit); two letters of support, each from a different academic (two-page limit); copy of the nominee’s project proposal, including a budget up to US$10,000 (10-page limit); and curriculum vitae of the nominee.

Unfortunately, we are unable to consider unsigned documents.

To be considered, please ensure that you have completed and submitted the online nomination on or before the closing date of the call.

All items marked with an asterisk (*) must be completed.

Note: You must click the “Save” button at the bottom of each page to save your responses.

If you have questions about completing this form, contact


 
  STEP 1 of 3  
  Nominee Information
 
  Title *
  Current position *
  Institution *
  Address *
  City *
  State or province *
  Country *
  Website
  Telephone number *
  E-mail address *
  Nationality *
  Specialty *
 
Date of birth as day/month/year *
Academic Degrees
(Please list in reverse chronological order)
Degree, Name of university, Year of graduation
* 1.
2.
  3.
  4.
  Recent Professional Experience
  (Please list in reverse chronological order)
  Title, Organization, Years
  * 1.
  2.
  3.
  4.
     
  Selected Publications
  Author(s), Date, Title, Journal, Volume, Number
  * 1.
  2.
  3.
  4.
  Selected Honors & Awards
  (Please list in reverse chronological order)
  * 1.
  2.
  3.
  4.
 
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