ÿþ<html xmlns:v="urn:schemas-microsoft-com:vml" xmlns:o="urn:schemas-microsoft-com:office:office" xmlns:w="urn:schemas-microsoft-com:office:word" xmlns:m="http://schemas.microsoft.com/office/2004/12/omml" xmlns="http://www.w3.org/TR/REC-html40" xml:lang="en"> <head> <meta http-equiv=Content-Type content="text/html; charset=unicode"> <meta name=ProgId content=Word.Document> <meta name=Generator content="Microsoft Word 12"> <meta name=Originator content="Microsoft Word 12"> <base target="_top"> <link rel=File-List href="awardsdepaepewillemsapplicationform_files/filelist.xml"> <link rel=Edit-Time-Data href="awardsdepaepewillemsapplicationform_files/editdata.mso"> <!--[if !mso]> <style> v\:* {behavior:url(#default#VML);} o\:* {behavior:url(#default#VML);} w\:* {behavior:url(#default#VML);} .shape {behavior:url(#default#VML);} </style> <![endif]--> <title>PIANC website</title> <!--[if gte mso 9]><xml> <o:DocumentProperties> <o:Author>Marleen</o:Author> <o:Template>Normal</o:Template> 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</style> <![endif]--> <meta content="Consonant bvba" name=Author> <meta content="waterborne transport, ports, waterways, pianc, aipcn, pianc-aipcn, international, national, association, international navigation association, international navigation, van den eede, PIC, PTC I, PTC 1, PTC 2, PTC II, COMCOM, PEC, PCDC, SRN, gustave willems, willems, pianc bulletin, bulletin, navigation, navigator, navigate, naval, navigational, sea traffic, seafaring, inland navigation, pleasure navigation, port infrastructure, manoeuvre, manoeuvring, ship, shipping, shipment, shipbuilding, boat, vessel, cargo, cargo load, cargoes, transport, transportation, vessel, tanker, oil tanker, ocean, oceanic, water, aquatic, canal, channel, sea, silt, marina, marine, maritime, river, stream, waterway, freshwater, coast, coastal, port, haven, harbour, lock, quay, jetty, pier, dock, breakwater, coastal engineering, engineering, management, dredging, dredged, environment, environmental, nature, habitat, ecological, fender, port management, hazardous goods, shortsea shipping, intermodal, disposal" name=Keywords> <meta content="PIANC - Waterborne transport, Navigation, Ports, Waterways" name=Description> <!--[if gte mso 9]><xml> <o:shapedefaults v:ext="edit" spidmax="1026"/> </xml><![endif]--><!--[if gte mso 9]><xml> <o:shapelayout v:ext="edit"> <o:idmap v:ext="edit" data="1"/> </o:shapelayout></xml><![endif]--> </head> <body lang=EN-US link="#3366CC" vlink=purple style='tab-interval:36.0pt'> <div class=Section1> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b style='mso-bidi-font-weight:normal'><span style='font-size:18.0pt;font-family: "Century Gothic","sans-serif";color:#00147B'>PIANC De Paepe  <span class=SpellE>Willems</span> Award application form<o:p></o:p></span></b></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b style='mso-bidi-font-weight:normal'><span style='font-family:"Century Gothic","sans-serif"; color:#00147B'><o:p>&nbsp;</o:p></span></b></p> <p class=MsoNormal style='margin-bottom:12.0pt'><b><span style='font-size:9.0pt; font-family:"Century Gothic","sans-serif";color:#003366'>APPLICATION FOR THE AWARD<o:p></o:p></span></b></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>This form has to be completed and printed (click link in upper left corner of this box). The printout needs to be returned by the candidate, together with his or her article, to the General Secretariat of PIANC : <br> <br> <span class=SpellE>Graaf</span> de Ferraris, 11th floor - Box 3<br> Blvd. du <span class=SpellE>Roi</span> Albert II, 20<br> 1000 Brussels<br> Belgium<br> <br> If you wish, you can also send in your contribution electronically to <a href="mailto:info@pianc-aipcn.org"><span style='mso-bidi-font-size:9.0pt'>info@pianc-aipcn.org</span></a>. The same goes for the form <span class=GramE>below,</span> provided that it is sent as a scan and that your signature is on it.<o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b style='mso-bidi-font-weight:normal'><span style='font-size:18.0pt;font-family: "Century Gothic","sans-serif";color:#00147B'><o:p>&nbsp;</o:p></span></b></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#FF6600'>CLOSING DATE FOR RECEIPT OF ENTRIES IS 31 AUGUST</span></b><b style='mso-bidi-font-weight: normal'><span style='font-size:18.0pt;font-family:"Century Gothic","sans-serif"; color:#00147B'><o:p></o:p></span></b></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><b style='mso-bidi-font-weight:normal'><span style='font-size:18.0pt;font-family: "Century Gothic","sans-serif";color:#00147B'><o:p>&nbsp;</o:p></span></b></p> <table class=MsoNormalTable border=1 cellspacing=0 cellpadding=0 align=left width=516 style='width:387.0pt;mso-cellspacing:0cm;border:solid #0099CC 1.0pt; mso-border-alt:solid #0099CC .5pt;mso-yfti-tbllook:1184;mso-table-lspace:9.0pt; margin-left:6.75pt;mso-table-rspace:9.0pt;margin-right:6.75pt;mso-table-anchor-vertical: paragraph;mso-table-anchor-horizontal:margin;mso-table-left:left;mso-table-top: 138.8pt;mso-padding-alt:4.2pt 4.2pt 4.2pt 4.2pt'> <tr style='mso-yfti-irow:0;mso-yfti-firstrow:yes'> <td width=516 colspan=2 style='width:387.0pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><br> <b>PIANC De Paepe - <span class=SpellE>Willems</span> Award Application Form</b> <o:p></o:p></span></p> <div class=MsoNormal align=center style='text-align:center;mso-element:frame; mso-element-frame-hspace:9.0pt;mso-element-wrap:around;mso-element-anchor-vertical: paragraph;mso-element-anchor-horizontal:margin;mso-element-top:138.8pt; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif"; color:#003366'> <hr size=1 width="100%" align=center> </span></div> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:1'> <td width=177 style='width:132.4pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>Name :<o:p></o:p></span></p> </td> <td width=339 style='width:254.6pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:2'> <td width=177 style='width:132.4pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>Surnames :<o:p></o:p></span></p> </td> <td width=339 style='width:254.6pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:3'> <td width=177 style='width:132.4pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>Company :<o:p></o:p></span></p> </td> <td width=339 style='width:254.6pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:4'> <td width=177 style='width:132.4pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>Address :<o:p></o:p></span></p> </td> <td width=339 style='width:254.6pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:5'> <td width=177 style='width:132.4pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>&nbsp;<o:p></o:p></span></p> </td> <td width=339 style='width:254.6pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:6'> <td width=177 style='width:132.4pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>City &amp; postal code :<o:p></o:p></span></p> </td> <td width=339 style='width:254.6pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:7'> <td width=177 style='width:132.4pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>Country :<o:p></o:p></span></p> </td> <td width=339 style='width:254.6pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:8'> <td width=177 style='width:132.4pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>Tel :<o:p></o:p></span></p> </td> <td width=339 style='width:254.6pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:9'> <td width=177 style='width:132.4pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>Fax :<o:p></o:p></span></p> </td> <td width=339 style='width:254.6pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:10'> <td width=177 style='width:132.4pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>Email :<o:p></o:p></span></p> </td> <td width=339 style='width:254.6pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:11'> <td width=177 style='width:132.4pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>Date of birth :<o:p></o:p></span></p> </td> <td width=339 style='width:254.6pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:12'> <td width=177 style='width:132.4pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>Current professional Activity :<o:p></o:p></span></p> </td> <td width=339 style='width:254.6pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:13'> <td width=516 colspan=2 style='width:387.0pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p>&nbsp;</o:p></span></p> <div class=MsoNormal align=center style='text-align:center;mso-element:frame; mso-element-frame-hspace:9.0pt;mso-element-wrap:around;mso-element-anchor-vertical: paragraph;mso-element-anchor-horizontal:margin;mso-element-top:138.8pt; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif"; color:#003366'> <hr size=1 width="100%" align=center> </span></div> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:14'> <td width=516 colspan=2 style='width:387.0pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>Title of article :<o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:15'> <td width=516 colspan=2 style='width:387.0pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:16'> <td width=516 colspan=2 style='width:387.0pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:17'> <td width=516 colspan=2 style='width:387.0pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:18'> <td style='border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>Approximate number of words :<o:p></o:p></span></p> </td> <td width=339 style='width:254.6pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:19'> <td style='border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>Number of separate illustrations (if any) : <o:p></o:p></span></p> </td> <td width=339 style='width:254.6pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p></o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:20'> <td width=516 colspan=2 style='width:387.0pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p>&nbsp;</o:p></span></p> <div class=MsoNormal align=center style='text-align:center;mso-element:frame; mso-element-frame-hspace:9.0pt;mso-element-wrap:around;mso-element-anchor-vertical: paragraph;mso-element-anchor-horizontal:margin;mso-element-top:138.8pt; mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif"; color:#003366'> <hr size=1 width="100%" align=center> </span></div> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:21'> <td width=516 colspan=2 style='width:387.0pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; mso-element:frame;mso-element-frame-hspace:9.0pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:margin; mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt; font-family:"Century Gothic","sans-serif";color:#003366'>I certify that the accompanying article has been written solely by me<o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; mso-element:frame;mso-element-frame-hspace:9.0pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:margin; mso-element-top:138.8pt;mso-height-rule:exactly'><span class=GramE><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>and</span></span><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'> has not been published elsewhere. I have read and agree to be <o:p></o:p></span></p> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto; mso-element:frame;mso-element-frame-hspace:9.0pt;mso-element-wrap:around; mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal:margin; mso-element-top:138.8pt;mso-height-rule:exactly'><span class=GramE><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>bound</span></span><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'> by the <a href="../awardsdepaepewillemsrules.asp"><span style='mso-bidi-font-size: 9.0pt'>rules</span></a> of this competition. <o:p></o:p></span></p> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'><o:p>&nbsp;</o:p></span></p> </td> </tr> <tr style='mso-yfti-irow:22;mso-yfti-lastrow:yes'> <td valign=top style='border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='mso-element:frame;mso-element-frame-hspace:9.0pt; mso-element-wrap:around;mso-element-anchor-vertical:paragraph;mso-element-anchor-horizontal: margin;mso-element-top:138.8pt;mso-height-rule:exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif";color:#003366'>Date &amp; signature<o:p></o:p></span></p> </td> <td width=339 style='width:254.6pt;border:none;padding:4.2pt 4.2pt 4.2pt 4.2pt'> <p class=MsoNormal style='margin-bottom:12.0pt;mso-element:frame;mso-element-frame-hspace: 9.0pt;mso-element-wrap:around;mso-element-anchor-vertical:paragraph; mso-element-anchor-horizontal:margin;mso-element-top:138.8pt;mso-height-rule: exactly'><span style='font-size:9.0pt;font-family:"Century Gothic","sans-serif"; color:#003366'><br style='mso-special-character:line-break'> <![if !supportLineBreakNewLine]><br style='mso-special-character:line-break'> <![endif]><o:p></o:p></span></p> </td> </tr> </table> <p class=MsoNormal style='mso-margin-top-alt:auto;mso-margin-bottom-alt:auto'><o:p>&nbsp;</o:p></p> </div> </body> </html>