Nomination Form for SEPI Research Awards

Type of Award:  New Researcher Award ____    Dissertation award ____

Name of Nominee:  _____________________________________________

Affiliation:              _____________________________________________

Mailing address:     _____________________________________________

                           _____________________________________________

Email address:       ____________________________

Title of work submitted for the award: ______________________________

        ________________________________________________________

Nominator's name: _____________________________________________

Letter of recommendation from: ___________________________________

Checklist for submission:

 Hard     Electronic
 Copy    Attachment
_____       _____ Application Form
_____       _____ Copy of nominee's curriculum vitae  
_____       _____ Copy of dissertation proposal or paper (for New Researcher Award)
_____       _____ Letter of recommendation   

Submissions should be sent to the Chair of the SEPI Research Committee:

(please send at least a note by fax or regular mail AND email to avoid loss)

Prof. Dr. Franz Caspar
Leiter Abt. Klinische Psychologie und Psychotherapie
Universität Bern
Gesellschaftsstr. 49
3000 Bern 9
0041 / 31 / 631 54 16, Sekr.: 631 47 31
Fax 631 41 55
caspar@psy.unige.ch