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Please see our nomination guidelines for details on the prize categories and nominee qualifications.
The deadline for nominations for the 29th and 30th Fukuoka Prize is on September 30, 2017.

Fukuoka Prize Nomination Form
Nominee Details

Categoryrequired

In which of the following categories do you wish to nominate a candidate?

Individual or group/organizationrequired

Do you wish to nominate an individual, or a group/organization?

Sex

(max 1500 characters)

Please provide a short curriculum vitae of the nominee, with the date of birth, awards, and publications.

http://www.example.com/

Any relevant articles about the nominee, any academic papers written by the nominee, publications or additional documentation may be submitted either by e-mail or postal mail.

Please provide the following information about yourself as a nominator. As for your information, the secretariat shall keep its confidentiality.

Nominator Details

入力例:foo@example.com


Will you continue to cooperate as a nominator?

Please check the box below if you can. The Secretariat may send you an e-mail to ask nominations.

Thank you very much for your cooperation. Should submitted nomination form be incomplete, the Secretariat may send you an email to the e-mail address entered.

* Self-nomination is not permitted.
* Please fill out the form in English.

Nomination and additional documentation should be addressed to:

  • E-mail: acprize@gol.com
  • FAX: +81 (0)92 735 4130
  • Address: Secretariat of the Fukuoka Prize Committee
    c/o International Affairs Dept., General Affairs & Planning Bureau, Fukuoka City Government, Fukuoka 810-8620 Japan