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2008 FLATE Awards Nomination Form

Please fill in all the fields below.

 

Submission Date:

Which award are you nominating for (check one):




 

Nominee:

Name Job Position Employer
Address
City
 		State
 		Zip
Telephone Fax
 Email
     
     

Principal Nominator:

Name Job Position Employer
Address
City
 State
 Zip
Telephone Fax
 Email
     
     

References:

First Reference   2nd Reference  
Name



Name
Affiliation



Affiliation
Phone



Phone
Email

Email

 

Citation:

CITE IN 200 WORDS OR LESS the highlights of the nominee’s contributions, or qualifications, for the specific honor/award.



 

 

 

 

 

 

 

 

 





 



This material is based upon work supported by the National Science Foundation under Grant No. 0402215 - disclaimer