Nominee Details


Name:


Institute:

Department:

Address:



Country:  

E-mail:

Years of Teaching Experience:   


Upload supporting files:

Letter of Endorsement from current Department Chair/Dean (pdf only, 1 Page, 1MB max file size)

Curriculum Vitae (pdf only, 2 Pages, 1MB max file size)

Teaching Portfolio (pdf only, up to 12 Pages, 10MB max file size)


Nominated by: (for self-nominations, include only an e-mail where the acknowledgement of submission should be sent)
Name:


E-mail:

Phone:


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The European Council stores and processes this information in line with its privacy policy and applicable Belgian and European Laws. The information you are submitting with this form will be used only for the purposes of  EC3 award. For further information about how this data will be used please e-mail: awards@ec-3.org. If selected for the Prize you agree that your name and photo will be used on the EC3 website and other social sites.