NUCLEAR AND PLASMA SCIENCES SOCIETY

NOMINATION FORM FOR THE NPSS PHELPS AWARD

SUBMIT BY SEPTEMBER 1

Please supply as much of the following information as applicable to the individual.  Provide any additional information that you think may help the judges’ decision.

A.  NOMINATOR (must be a faculty member for student candidate)		OFFICE TELEPHONE NO.	     	

	Name  	     	

	Title  	     	College or University	     	

	Mailing Address  	     	

	     	

	Signature  	     	

B.  CANDIDATE (must be a graduate student or unemployed)		OFFICE TELEPHONE NO.	     	

	Name  	     	

	Mailing Address  	     	

	     	

	Degrees  	     	

	Present Field of Study  	     	

	Toward Degree of  	     	

	Plans for Next Year  	     	

	Scholarship:

	IF STUDENT,GPA (Indicate Whether in Major or Total)	     		

     Other Information (Awards, Honor Societies)
	     	

	     	

NOMINATION FORM FOR NPSS PHELPS AWARD				        Page 2

C.  NOMINATOR’S EVALUATION OF CANDIDATE:

     	

	(continue in part G, if necessary) (Note: The candidate is encouraged to separately submit a statement of his or her plans and ambitions for future study or work.)

D.  LIST ANY REPORTS OR PUBLICATIONS IN WHICH THE CANDIDATE HAS PARTICIPATED THAT ARE RELATED TO NUCLEAR AND/OR PLASMA SCIENCES.  COPIES SHOULD BE ATTACHED, IF POSSIBLE.  IN CASE OF MULTIPLE AUTHORS, A STATEMENT OF THE NOMINEEíS CONTRIBUTION WOULD BE APPRECIATED.

     	

NOMINATION FORM FOR NPSS PHELPS AWARD				        Page 3

E.  OTHER PROJECTS RELATED TO NUCLEAR AND/OR PLASMA SCIENCES:

     	

F.  WORK EXPERIENCE RELATED TO NUCLEAR AND/OR PLASMA SCIENCES:

     	

G.  LIST ANY OTHER INFORMATION THAT THE NOMINATOR CONSIDERS RELEVANT.

     	

SUBMIT BY SEPTEMBER 1 to:

Chair, Respective Conference
(Insert name and address here)