Applicant Background Information
* Mandatory / must be field
First Name*

Last Name*

Email Address*

Place/Date of Birth*

Phone Number (please include your country code)

Address*

Country(ies) where you hold citizenship*

Education & Employment
Name of university where you obtained your doctoral degree or equivalent*

Area of expertise/study*

Current employer*

Current title*

Briefly explain your current position*

Please list any professional associations/affiliations of which you are a part

Other
How did you hear about the prize?*

Scientific Excellence
What is your research title?*


Describe you research, technology or business model and how it relates to the 2023 prize topic of “Electrification.” Areas of impact could include but not limited to the following: *
• Develop electrification technology that promotes the use of electrical power and therefore combat climate change;
• Develop methods that replace use of fossil fuels (coal, oil, and natural gas) with technologies that use electricity a source of energy which helps reduce emission of carbon dioxide (CO2) from transportation, building, industrial and other sectors;
• Apply electrification technology and innovations in reducing the use of fossil fuels to help decarbonize the economy and mitigate the impacts of climate change;
• Assist communities to utilize renewable energy, which provides electricity access for all and reduce electricity costs for consumers;
• Inspire and motivate other women scientists and researchers to work on this topic or other relevant STEM topics.


Describe any awards, merits, or official recognition you’ve received throughout your scientific career. If none, please insert N/A.*


Has your work been featured in the media, academic journals, policy briefs, or any other substantial publications? If yes, please share three of the notable or unique pieces in which you’ve been featured, and in a few sentences, explain why you selected these three?*


In one paragraph, please share how you wish to grow as a scientist.*

Mentoring, inspiring, and supporting women and up-and-coming female members of the STEM community
Explain how you mentor, support and/or empower female students, colleagues or other women in STEM. Please provide specific examples.*


Describe how your technology, business practice, or research account for gender participation. Does your work specifically target female stakeholders or integrate gender inclusive practices?*


Share what you are doing to improve opportunities for women in STEM. If you belong to organizations focused on this goal, please share details about the organization and your unique role/contribution.*

Global Citizen
Explain how your work, leverages on the use of science, technology and innovation; help to close development gaps throughout the ASEAN region and beyond.*

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