* required fields

Nomination presented by
(if other than the candidate himself/herself):

Name of candidate*:

Street address*:

E-mail*:

Website:

If the candidate is an organization

Type of organization:

Date of establishment:

Brief history and general information:

Publications and materials (CD-ROMs, cassettes, videocassettes) produced by the candidate relating to the accessibility and preservation of documentary heritage:

Please attach information leaflet if available:
[Maximum file size allowed is 300 KB]

If the candidate is an individual (nomination must be submitted by a third party)

Nationality:

Education:

Professional experience:

Publications and materials produced by the candidate relating to the accessibility and preservation of documentary heritage:

Please send a brief curriculum vitae (1 or 2 pages):
[Maximum file size allowed is 300 KB]

Describe the way in which the work nominated has made a significant contribution to the preservation and accessibility of documentary heritage (use separate sheet if necessary):

Describe the impact of this contribution to the preservation and accessibility of documentary heritage, whether at the local, national, regional or international level (use separate sheet if necessary):

Has the candidate received previously any award for the same contribution? If yes, briefly indicate which prize:

Explain briefly how the UNESCO/Jikji Memory of the World prize money would be used:

Please attach illustration material or indicate web site(s) where the nominated work could be consulted:
[Maximum file size allowed is 300 KB]

or indicate web site(s) where the nominated work could be consulted: