Nomination Submission

Nomination for Prince Mahidol Award 2023

I. NOMINEE


II. MAILING ADDRESS


III. JUSTIFICATION FOR NOMINATION


IV. STATEMENT IN SUPPORT OF NOMINATION

Please provide details of the best or the most significant contribution of the candidate.


V. AWARDS AND HONOURS RECEIVED


VI. EDUCATIONAL BACKGROUND


VII. POSITIONS OCCUPIED


VIII. PUBLICATIONS


IX. NOMINATED BY


X. Attachment


Note

  1. Please give full information on the category III & IV. Well prepared statements which are verifiable will be of value to the nominees and to the selection commitees.
  2. Please send not more than two letters of references, that could add more information and justification for the nomination, along with the nomination.
  3. In case the nominee is an institution, please attach documents on the history, status and key officials of the institution (s). Use additional paper for each category for information as necessary.