Visiting Professor Education Innovation Prize

Application Form

Please complete the form and click the Submit button at the bottom of the page. Once you submitted the form, you will receive a confirmation e-mail at the e-mail address you give on the form.

(*) Indicates required fields

	Name of the Visiting Professor being proposed*
	Name, position & contact details of Proposer*
	Name, position & contact details of the two independent referees who will be submitting statements in support of two Visiting Professor*
	Summary of Submission
	Please describe in no less than 200 or more than 500 words what distinguishes the work of this Visiting Professor and why you think they should be the winner of this prize*
	Supporting material
	Please list below any supporting material which accompanies this form*
	E-mail*
	Signed*
	Date*	(dd/mm/yyyy)
	Before you can submit your request, we need to make sure it is not an automated computer program that's submitting the form. To achieve this, please enter the two words displayed below in the textbox, separated by a space.

Please click only ONCE and wait for the form to be submitted.

Please send the form to:

Ian Bowbrick
Head of Professional Formation

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Education Innovation Prize Application form Instructions for proposers Instructions for referees