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Outstanding Chapter Award Nomination Form
Form 5: 2024 Outstanding Chapter Award Nomination Form
Nominator Information:
IEEE Function:
IEEE Membership Info.
Student member
Member
Senior Member
Fellow
Contact Address
Email:
Phone:
Fax:
IEEE AP-S Chapter Information:
Name of IEEE Section:
Name of IEEE AP-S Chapter:
IEEE Section Information:
Détail of IEEE AP-S Chapter web site:
Total AP-S Members:
Chapter Officers (Chair, Co-Chair, Treasurer, Secretary) Information:
IEEE Function:
IEEE Membership Info.
Student member
Member
Senior Member
Fellow
Contact Address
Email:
Phone:
Fax:
IEEE AP-S Chapter and Chapter Board:
Date of establishing the Chapter (AP-S or Joint Chapter):
Date of last election of the Chapter Board:
Chapter Membership and Membership Development (Fill the data as per availability):
Number of Regular, Associate, and Affiliate members
Variable
Response
Regular, Associate/ Affiliate members | as of Dec 31, 2023
Student Grade Members
Variable
Response
Student Grade Members | as of Dec 31, 2023
Fellows
Variable
Response
Fellows | as of Dec 31, 2023
Senior Members
Variable
Response
Senior Members | as of Dec 31, 2023
Total membership
Variable
Response
Total membership | as of Dec 31, 2023
IEEE Senior Member Initiative:
Has the Chapter nominated/endorsed Members to Senior Members successfully? If yes, how many?
IEEE Senior Member Initiative:
Has the Chapter nominated/endorsed Members to Senior Members successfully? If yes, how many?
IEEE Fellow Nomination:
Has the Chapter been involved in Fellow nominations? Has it been successful?
IEEE Member-Get-a-Member Campaign:
List of innovative membership development programs/activities/results of the Chapter
Technical Activity
List and Provide a Short Characterization of Meetings (dates, attendance, speaker names):
#
Date
Attendance
Name of Speaker
1
Add New Data
Please attach a copy of one of the meeting programs and provide IEEE Vtools link
Student design contests, workshop, and other events:
Administrative Activity:
Reporting of new Chapter Officers to IEEE MGA and AP-S Chapter Coordinator
Uploading the events on Vtools and reporting L-31 Forms for IEEE Hqr. requirement
Did the chapter send a representative to any AP-Society Chapter Chair meeting last year? (please indicate what meeting and who the representative was)
Has the annual report been submitted to your Section?
Has the financial report been submitted to your Section?
List of Society, Section, etc. Awards received by the Chapter, if there are any?
Award Justification:
Why should your chapter be considered as an “Outstanding Chapter Award?
List of Attachments
Date of Submission
Form Submit By
Submit
