PCCP Prize Form (参考例)
The Chemical Society of Japan
	 	Date: Year/ Month / Day(提出日)	
Research Topic
	Dynamic aspects and associated structures of TiO2(110) and CeO2(111) surfaces relevant to oxide catalyses
→春季年会の講演演題ではなく、今回の応募理由となる業績に関するタイトルを付けてください。なおこのタイトルに合致する内容を下記のAbstractにご記述ください。	
Name	Dr. Taro Kagaku （化学　太郎）
→氏名英文表記にはDr./Mr./Prof.等称号をつけ、和文氏名も併記してください。	
Date of Birth (age)	Year/ Month / Day
→生年月日と、2024年4月1日現在の年齢を記入してください。	

Affiliation
(Current Position)
	Associate Professor of Chemistry
University of Kagaku
Graduate School of Chemistry, Faculty of Science
→准教授、助教授、教授、研究員など現在の職階を明記して下さい。	
Address
(Full address, Tel, Fax, Email)	1-5, Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8307, Japan
Tel. 03-3292-6163, FAX. 03-3292-6318, Email. pccp@chemistry.or.jp
→連絡の取れるメールアドレスを記載願います。	

Division Registered
	Physical Chemistry 
→複数ある場合には、今回書類を提出するディビジョンのみご記入願います。	
Registration #	［受付番号］は C+6桁の番号 です。例）C002846
→今年の春季年会の受付番号を記入して下さい。A講演は対象外です。	
Membership #	2XXXXXXX00
→10桁の会員番号をご記入ください。	

Academic Carrier

	2009 B.S. degree, Kagaku Univ.
2011 M.S. degree, Graduate School of Science, Kagaku Univ.
2013 Ph. D. degree in Engineering, Graduate School of Science, Kyoto Kagaku Univ.
2014 Postdoctoral Research Fellow (DC2), Japan Society for the
Promotion of Science (JSPS)
2016 Research fellow, Inst. Physical Molecular Science
2020 Associate Professor, University of Kagaku	

Previous Award(s)
	The Chemical Society of Japan Award for Young Chemists for 2019
Kagaku Medal 2021 (by CSJ)	
Abstract
(Approx. 500 Words)

List of Publications
(attached separately)	This article gives a topical review of the dynamic behavior of surface species on two representative metal oxide surfaces of TiO2(110) and CeO2(111) investigated by scanning tunneling microscopy (STM) and noncontact atomic force microscopy (NC-AFM). In addition, two new aspects, the self-limiting growth of Pt nanoparticles from MeCpPtMe3 on TiO2(110) regulated by a competitive reaction with TiOx suboxides and the inhomogeneous reactivity of surface oxygen atoms on CeO2(111) against methanol, are also imaged by STM and NC-AFM, which are relevant to key issues to understand the surface chemical reactivity and catalysis. 
→春季年会での講演要旨ではなく今回の応募理由となる業績について記述してください。	

PCCP Prize Form
The Chemical Society of Japan
	 	Date: Year/ Month / Day(提出日)	

Research Topic

Name
		
Date of Birth (age)	Year/ Month / Day (age)	

Affiliation
(Current Position)

	

Address
(Full address, Tel, Fax, Email)

Division Registered

Presentation #/Registration #

Membership #

Academic Carrier

Previous Award(s)
		
Abstract
(Approx. 500 Words)

List of Publications
(attached separately)