SurveyMonkey Powered Online Survey

You are invited to submit the nomination form with the following procedure:

Complete to fill all required information by a nominated expert,
Before clicking "Next" button, print out the completed form. If you forgot to print this page and move to the next page, please go back to the previous page by using your browser function.
Click "Next", then "Done" buttons at the end of the form. This step is essential to register your information to the online database, to be used for the selection process.
On a printed form, obtain a signature by a Permanent Representative to WMO or a IOC Action Addressee
Submit the signed form, either by fax or by email, to:

WMO (email: mmo@wmo.int, fax: +41 22 730 8128) and/or
IOC (email: f.collins@unesco.org, fax: +33 1 45 68 58 10)

Please note that only those submissions with signature from the WMO/PR or IOC/AA will be considered.

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* 1. Country

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* 2. Name of the Expert

Family name

First name

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* 3. Date of birth

DD/MM/YYYY

Date

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* 4. Gender

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* 5. Nationality

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* 6. Contact Information

Telephone

Telefax

Mailing Address

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* 7. Proposed JCOMM group/expert team membership, for which nomination is being made:

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* 8. Employing institution and position held. If possible, please limit the length of the input within 20 lines:

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* 9. Concise description of relevant work experience (duties, major projects, research, etc.) that pertain to the above activities. If possible, please limit the length of the input within 20 lines.

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* 10. List of selected publications (technical reports, research papers, etc.) on the above activities. If possible, please limit the length of the input within 20 lines:

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* 11. Date of return to home country

	Excellent	Good	Fair	N/A
English	English Excellent	English Good	English Fair	English N/A
French	French Excellent	French Good	French Fair	French N/A
Russian	Russian Excellent	Russian Good	Russian Fair	Russian N/A
Spanish	Spanish Excellent	Spanish Good	Spanish Fair	Spanish N/A
Chinese	Chinese Excellent	Chinese Good	Chinese Fair	Chinese N/A
Arabic	Arabic Excellent	Arabic Good	Arabic Fair	Arabic N/A

Mother Tongue

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* 12. Today's Date

Date

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* 13. Signature of the Permanent Representative with WMO or the IOC Action Addressee

Please print out the completed form: <<< Print >>> to obtain the signature, then click the "Next" button below.

The signed form should be submitted to

WMO (email: mmo@wmo.int, fax: +41 22 730 8128) and/or
IOC (email: f.collins@unesco.org, fax: +33 1 45 68 58 10)