Awards Nomination Form, Member, Region 5

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Institute of Electrical and Electronics Engineers

Awards Nomination Form, Member, Region 5

Source: Region 5 Officer Training Manual.

IEEE REGION 5
OUTSTANDING MEMBER
NOMINATION FORM

Nominee:_______________________________________________

Address:_______________________________________________

Phone: Work: ( )_____-______ Home: ( )____- ______

Nominating Unit(Section, Sub-Section, Society Chapter, Student Branch):

Describe in narrative form the nature of the outstanding service which the nominee has rendered to the IEEE at the local, regional, and/or national level. This could be exemplary service over an extended period of time or specific service rendered over a short time span.

Submitted by: _______________________________________________________

Member Number:_______________________________________________________

IEEE position:_______________________________________________________

Address: _______________________________________________________

Phone: ( )____ - ______

The following are the weighting percentage points for the listed activities:

a.) Must be IEEE member

b) Long-term service

20% Service to Local Unit
20% Service to Regional Unit
10% Service to Institute

c) Specific one time activity

50% Service to the IEEE, its members, or general society on behalf of the IEEE

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Last updated May 04, 2008.