NOMINATION FORM FOR 2016 PRIZE

Each nominator may propose outstanding individuals or teams for the Prize and complete the following form (one form per nominee) with:
-	Contact information
-	A specific description of the nominee’s major advancement in nutrition science, including new concepts and research fields with its potential application for human diet and health, and the related key-words,
-	A paragraph describing the scientific rationale for the nomination,  
-	A short list of 10 to 15 publications documenting the nominee’s research leading to a major advancement in nutrition science, including the most recent publications (All research related to the “major advancement in nutrition science” must be published in the public domain, in English)
-	Of  these 10 to 15 publications, complete pdf files of five of the most relevant publications
-	A Nominee’s academic CV detailing the main achievements on education, appointments, members of Committees and Associations, PhD tutoring, self-funding ID and scientific Management and a 10-year track record.
The nomination form may be downloaded from the Danone Institute International website at:
www.danoneinstitute.org

INFORMATION REGARDING THE NOMINATOR 
Name of the nominator:
Institution of the nominator:

I, the undersigned __________________________________________, agree to participate as a Nominator for the 2016 Danone International Prize for Nutrition and, in accordance with article four of the Rules and Regulations, I attach a nomination proposal for the Prize.
Dated: _____________________2015
Signature:

NOMINEE’S CONTACT INFORMATION
Full Name and title of the nominee:

Primary academic institution:
Address: 

Zip code: ________________________________ City: ____________________________________________
Country:
Phone: 
Email:
Type of nomination:
•	Individual nomination
•	Team nomination 
      Other members of the team:	
      
Attach Academic CV 
The Academic CV can not exceed 4 pages and should contain 2 parts:
•	The main achievements with the following information: 
•	education,
•	appointments, 
•	member of Committees and Associations, 
•	PhD tutoring, 
•	self-funding ID ( list of main projects and a detail of current R&D projects),
•	Scientific management and further merits.
•	10-year track record which should introduce a list of the top 10 publications with indication (if possible) of the ISI field, the impact factor and quartile as senior author. You also have to indicate the invited research monographs, the chapters in collective volumes, any translations thereof and granted patents of the last 10 years.

DESCRIPTION OF THE SELECTED MAJOR ADVANCEMENT IN NUTRITION SCIENCE,      INCLUDING THE PROPOSED NEW CONCEPT OR RESEARCH FIELD WITH ITS POTENTIAL APPLICATION FOR HUMAN DIET AND HEALTH

Related key words:

SCIENTIFIC RATIONALE FOR THE NOMINATION

Short list of 10 to 15 publications documenting the major advancement in nutrition, including the most recent publications (All research related to the “major advancement in nutrition” must be published in the public domain and in English)

Of these 10 to 15 publications, provide the pdf file of five of the most relevant publications

DANONE INTERNATIONAL PRIZE FOR NUTRITION
Administrative secretary
Eficom Santé for DIPN 2016
2 rue Lechapelais
F-75017 Paris – France
Email : dipn2016@gmail.com	DANONE INSTITUTE INTERNATIONAL
Route départementale 128
F-91767 Palaiseau – France
www.danoneinstitute.org

Please submit the form by email, before April 6th, 2015
to dipn2016@gmail.com