SIGMA XI FACULTY RESEARCH AWARDS
Nomination Form

1. Name of the Candidate:
2. Department:
3. Position title:
4. Formal Education and Degrees:
5. Principal Professional Society Memberships:
6. Professional Recognition (honors, awards, honorary degrees, etc, with dates):
7. Research publications (total no. ________); patents (total no._________). Please list the five (5) most significant publications/patents. You may attach copies.
8. Professional Experience (teaching, research, consulting, etc.)
9. Description and importance of specific outstanding research achievement and contributions to scientific knowledge.
10. Nominated by:
Name, Campus, Address/Affiliation, Phone
11. Three Letters of support by:
List Name and Address/Affiliation and attach letters

Please send nominations, including supporting letters by Friday February 1, 2013 to:

Cindy Nakatsu
Sigma Xi
Department of Agronomy
915 West State Street
West Lafayette, IN 47907-2054