Application form


The Prof. dr. Marijan Hanžeković Foundation

Smičiklasova 21, 10000 Zagreb, tel. 01/4819 363, fax 4819 365,
 

Application form for the annual Prof. dr. Marijan Hanžeković Prize [ PDF] 

An author must complete and sign this application form as a condition for participating in the competition.  If the paper has been co-authored, each of the authors should fill in his or her own application form, which should be sent in a sealed envelope together with a curriculum vitae.

Title of the paper:

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Name:

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Surname:

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Title:

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Occupation:

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Date of birth:

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Place address:

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Telephone number:

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e-mail:

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Home address:

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Telephone number:

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e-mail:

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I certify that I have read and understood the conditions of the competition and that I shall abide by them. 

I enclose my curriculum vitae.

Place and date: ________________________________

Signature: ________________________________

 

Send to the address:
Zaklada "Prof. dr. Marijan Hanžeković"
Smičiklasova 21, Zagreb