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Education Award Nomination Form
Name
(Required)
First
Last
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Award being requested
(Required)
Archimedes Award
Emory Erickson Award
Gladstone Award
Jadzia Dax Award
Keiko O'Brien Award
Nicolaus Copernicus Award
Uhura Award
Vidiian Exploratory Award
Yuri Gagarin Award
Science Officer of the Month
Science Officer of the Year
Region of the Year – Sciences
Heim Award
Please attach any supporting evidence for your award application
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Max. file size: 98 MB, Max. files: 35.
Declaration
(Required)
I declare that the evidence I am submitting is true and correct.
Membership
(Required)
I confirm that I am a member of SFI Sciences and filled out the membership form
Acknowledgement
(Required)
I acknowledge that my enquiry and data shall be processed as detailed within the SFI Privacy Policy
SFI Privacy Policy
If you are requesting this award for someone else, please provide your name, scc and email address and date required
