All requested information must be provided All materials must be submitted in English Date * Month MonthJul Day Day16 Year Year2019 Nominee * (Include Current Title): Nominee Email: * Nominee Work Phone * Nominee Home Phone Nominee Cell Phone Most recent affiliation and current address: * List 1 to 5 publications by the nominee that exemplify the nominee’s contributions to Cosmology: * Cover letter explaining what the nominee has done and why it is important in Cosmology (broadly interpreted). Please make it concise, but long enough to make the case. * (250 – 1000 word limit): Nominator: * Nominator Email: * Mailing Address: * Nominator Work Phone * Nominator Home Phone Nominator Cell Phone Nominator Fax (enter ‘None’ if none) Curriculum Vitae: Please attach the nominee's curriculum vitae WITHOUT a full list of publications. If you are unable to attach the CV, you may e-mail it to: firstname.lastname@example.org The required letter of support must be supplied by the deadline or the nomination is invalid. Submit NominationFiles must be less than 2 MB.Allowed file types: gif jpg jpeg png txt pdf doc docx. CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions.