Name of Unit:_____________________________________________

Chairman of Unit:_________________________________________

Address:__________________________________________________

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

Planning: Describe the Strategic plan and the program planning of the unit for the year and how it integrates with the Region and national goals.

Meetings: Describe meeting activities during the past year, emphasizing improvements including such things as number of meetings, attendance, quality of programs, special features, etc.

Continuing Education/Professional Development: Describe continuing education and professional development activities during the past year, emphasizing improvements including such things as number of offerings, participation, improvements over past year, planned future offerings, etc.

Membership: Discuss the changes in membership during the past year including such things as methods used to increase memberships, upgrade members, etc.

Cooperation/interaction: Discuss cooperative orjoint activities with other IEEE units as well as other professional or technical societies or organizations.

Special Activities/innovations: Describe and special activities or innovations of the unit during the past year.

Submitted by: _______________________________________________________

Member Number:_______________________________________________________

IEEE position:_______________________________________________________

Address:       _______________________________________________________

Phone:        (    )____ - ______

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