Oronzio De Nora Foundation Young Author Prize

							              Oronzio and Niccolò De Nora Foundation
                        Young Author Prize
                      Application Form 2009
    This filled in form with all required nomination documents in either MS-WORD or PDF format should be
     sent on a CD-ROM or DVD to the address below.
or alternatively, the application and the documents may be uploaded via FTP, following the instructions which
     may be obtained from the ISE Office (info@ise-online.org). Applications submitted in printed form are no
     longer accepted.

APPLICANT
Last name:_______________________________                   First name:____________________________

Birth date (DD/MM/YYYY):_______________________________

Address:__________________________________________________________________________

City:______________________________________ Country:______________________________

e-mail:___________________________________________________________________________
Bibliographic reference of the article attached to the application:
Electrochimica Acta Vol. ______ (2008)        pages ____________________________________

The following items must be attached to this form
 Curriculum vitae
 Paper published in Electrochimica Acta, in the calendar year preceding the award (2008) in
PDF format. [Note: The paper must have a full page citation in 2008; on-line “article in press”
versions are not accepted].
       In case of co-authorship, a senior co-author must certify the contribution of the applicant to
       the published paper, using the form below.

SENIOR CO-AUTHOR
Last name:_______________________________                   First name:____________________________

Address:__________________________________________________________________________

City:______________________________________ Country:______________________________

e-mail:___________________________________________________________________________
I certify that the APPLICANT contributed in a substantial way to the paper published in:
Electrochimica Acta Vol. ______ (2008) pages ____________________________________
of which I am a co-author

Signature of the Senior Co-Author: ______________________________


                               International Society of Electrochemistry
                               Rue de Sébeillon 9b
                               1004 Lausanne
                                Switzerland
1 November 2008