Along with this application-questionnaire completed and signed, you should send us, for each scientific degree, a hard copy of a document certificating it (and of the witnessed translation of the document into either English, German, Russian, or Ukrainian in the case of another language of the document).
In order to completely represent your achievements at the Web site of the Academy, you are also asked to send us the corresponding .doc file in English (per e-mail).
APPLICATION-QUESTIONNAIRE for Joining
I, (surname, 1st and 2nd names),
born on (date),
accept the statutes of the All World Academy of Sciences "Collegium" and ask you to select me as a participant of this Academy.
Ph. D. dissertation defended on (date)
at (institution),
affirmed by (e.g., the Highest Attestation Commission of the ex-USSR).
Dr. Sc. dissertation defended on (date)
at (institution),
affirmed by (e.g., the Highest Attestation Commission of the ex-USSR).
Applicant’s post address:
Telephone:
Fax:
E-mail address:
Internet address:
Main scientific achievements (e.g., new problems, ideas, principles, methods, concepts, theories, sciences, phenomena and laws of nature, society, and consciousness):
Main scientific publications (at all … monographs, … articles):
Scientific interests:
Areas of competence (widely, e.g., physics, medicine):
Themes of lectures prepared:
Additional information (e.g., academician of … academy, winner of … prizes, themes and specialties of dissertations, workplace, position, etc.):
At the Web site of the Academy, along with my name and surname, I ask you to place the following:
(For example:
All information above, except my post address.)
Date:
Signature: