Application Form

To submit your work for consideration, please complete the following online form by 11:59 PM ET on Friday, November 30, 2012. In instances with multiple authors, please submit the online form and paper only once under one author and note additional authors in the relevant field.

* Required Field

First Name*:
 Middle Name:
 Last Name*:
Affiliation*:
Address 1*:
Address 2:
City*:
 State*: Zip*:
Country*
Phone*: Phone 2: Fax*:
Email*: Citizenship*:
Paper Title*:
  
Paper Category (practitioner or academic)*:
Additional Authors (first and last names and affiliation of each):
Is this an original paper created specifically for the award?*: Yes No
Is this a previously published paper?*: Yes No
If yes, where and when?*
 
How did you hear about the award?*
 
I acknowledge that winning report author(s) are fully responsible for
all applicable taxes: Yes No
Attach Paper Here (as PDF or Word document, 5MB maximum):    

RELEASE
I grant the IRRC Institute a license to publish, reproduce and publicize the paper submitted, should it be selected as a winning paper. I understand that this license is for physical and electronic publication, in all media whether currently known or unknown. I further represent that I am the owner of the copyright and have the ability and authority to make such a grant of license. (NB: If you are submitting a previously published paper where the copyright was granted to the publisher, or if the copyright is otherwise held by someone other than the person submitting the paper, please submit authorization from the copyright holder.    I agree.