NIAS Fellow Registration Form – Nominated fellows

A number of fellowships at NIAS are nominational fellowships, awarded together with partners. The form below is to be filled in by scholars, artists, writers and journalists who receive one of these fellowships. The information provided will be used by NIAS for administrative purposes, as well as to introduce our fellows, highlight their backgrounds, and share details of their research during their time at NIAS.

Questions?

Please contact Annette Mullink at partners@nias.knaw.nl

Step 1 of 4

Personal Information
Title
e.g. Prof, Dr, DRS, Mr, Ing, Ir
Name as in passport*
First Middle Last
Preferred name
If different from name in your passport
First Middle Last
Gender*
- Male
- Female
- Gender queer
- Rather not say
Date of Birth*
Day
Month
Year
Place of Birth*
Nationality
Second nationality
Home address*
Home postal code*
Home: city*
Home country*
Phone*
Preferably a mobile phone number
Private email address*

Personal email address
Work email address*

You will receive the acknowledgement of receipt on this email address. Make sure this field is filled out correctly.
Link to your personal website
Are you active on social media? If so, please add your social media handles.
LinkedIn Instagram Facebook Other

We would greatly appreciate it if you could mention your affiliation as NIAS-Fellow in your bio (linkedin.com/company/nias-knaw, @nias_knaw on Instagram and @niasknaw on Facebook).