Las Cumbres Amateur Outreach Award Nomination Form

Fill out form online by typing into the text boxes. Print the form from your browser and return by
15 December of nominating year to:

Las Cumbres Award Nomination
Astronomical Society of the Pacific
390 Ashton Avenue
San Francisco, CA 94112
   
Name of nominee:
Address:
Address 2:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
Fax:
Email:
   
Reason for nomination
(75 words or less):
 
Attach nominating letter giving a brief description of nominee's positions, affiliations, accomplishments, publications, etc. (for publications, please list name of author(s), volume/number, pages(s) and dates).
 
Letters of Support from others familiar with the nominee's accomplishments are an essential part of the nomination materials. Please indicate the names and e-mail addresses of at least three persons you have requested to provide support letters. The letters should be forwarded by you or sent directly to the ASP.
Name of Supporter 1:
Email:
   
Name of Supporter 2:
Email:
   
Name of Supporter 3:
Email:
   
Name of person making nomination:
Address:
Address 2:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
Fax:
Email:
 
Signature of nominator:
 __________________________________________________
Date:


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