Klaus Liebscher Award

Personal Data

Courtesy title: *

Please select ... Ms. Mr.

Academic degree:

First name: *

Last name: *

Date of birth (dd.mm.yyyy): *

   

Citizenship: *

Please select ... Austria Belgium Cyprus Czech Republic Denmark Estonia Finland France Germany Greece Hungary Ireland Italy Latvia Lithuania Luxembourg Malta Netherlands Poland Portugal Slovakia Slovenia Spain Sweden United Kingdom Bulgaria Croatia Romania Turkey

Company/Institution:

Street name and number: *

Postal code: *

Town: *

Country: *

Phone: *

Fax:

E-mail: *

Information about the Paper

Title of the paper: *

Has the paper already received awards or has it been submitted for other awards or grants? If so, where?

Has the paper or have parts thereof been published previously? If so, where?

The following documents have to be submitted ...

- application
- your paper
- curriculum vitae
- proof of citizenship
- certificate of birth

After submission you will receive detailed information on the required documents via e-mail.