HIDEYO NOGUCHI AFRICA PRIZE

Any personal information contained in the submitted nomination form and supplementary documents will be handled with the utmost care in accordance with the Act on the Protection of Personal Information (in the case of medical research, Act on the Protection of Personal Information Held by Incorporated Administrative Agencies, etc. and JSPS’s own regulations for protecting personal information), and will only be used as part of the selection process for the Hideyo Noguchi Africa Prize (including the provision of personal information to private-sector companies or other external partners for the purpose of carrying out consigned electronic data processing and data management). By submitting these nomination documents, you hereby agree to the use of said personal information for the aforementioned purposes.

Be sure to input all fields with asterisk (*).
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Nominator
Name *
（up to 32 characters）
Designation *
（up to 128 characters）
Organization Name *
（up to 128 characters）
Address
（up to 128 characters）
Telephone
（up to 32 characters）
Fax
（up to 32 characters）
E-mail Address *
E-mail Address(confirm) *
How did you learn about the nomination of the Hideyo Noguchi Africa Prize?
Please select all that apply.		 Letter from Office of Hideyo Noguchi Africa Prize, Cabinet office
Cabinet office website
Letter from JSPS
E-mail from JSPS
JSPS website
JSPS Monthly
JSPS Alumni Network
E-mail from Nature
E-mail from Science
E-mail from Foreign Press Center Japan
Others
Nominator Password *
Nominator Password(confirm) *
＊ID and password cannot be reissued, so please be careful to keep them.

Please contact JSPS (nh-africa@jsps.go.jp) by email if you have any questions regarding Medical Research.