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Awards Nomination Form, Student Member, Region 5 |
Source: Region 5 Officer Training Manual.
IEEE REGION 5
OUTSTANDING STUDENT 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 or student member
b) Long-term service
c) Specific one time activity
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Last updated September 16, 2011.