IEEE Founders Medal Nomination Form

IEEE Founders Medal, for outstanding contributions in the leadership, planning, and administration of affairs of great value to the electrical and electronics engineering profession.

This is a web interactive form. This form can also be downloaded in MSWord and .pdf formats.

Nominator Guidelines

1. Name of Candidate(s):

2. IEEE Member: Yes No

IEEE Grade Year Member #

3. Year of Birth

4. Professional Affiliation and Title

5. Business Address (include Email)

6. Home Address

7. Education beyond twelfth grade. Please include Institution/Location, degree, year received and Honors. Honorary degrees denoted (H).

8. Endorsers, Names and Addresses, Email. Endorsers should be familiar with the nominee's achievements and should state specific achievements that qualify the candidate for this award. Endorsers should also include a statement indicating how long they have known the candidate and in what capacity. (Minimum of three supporting letters required; maximum of five permitted. No more than five letters will be reviewed by the Committee. Letters may accompany nomination or be submitted directly to IEEE.)

9. Proposed Citation. (No more than 25 words.)

10. Principal Employment: Year; Name of Company; Title; Brief, Concise Description of Responsibility.

11. Principal publications and/or patents pertinent to the achievement. (Prefer items of sole responsibility, otherwise give joint names.)

12. Achievements pertinent to the qualifications for the IEEE Founders Medal. (Criteria considered by the Evaluation Committee shall include:(outstanding leadership, planning, or administration of affairs related to the profession; major industry administrator; manager of complex scientific mission; an additional consideration is service to the IEEE beyond normal expectation.) The quality of the nomination is also considered. (Do not exceed 1200 words.)

13. Principal IEEE Activities; Dates, Description.

14. Other Principal Professional Activities; Dates, Description.

15. Principal Honors (non-IEEE)

16. IEEE Honors/Awards

17. Nominator's Name; Business Affiliation & Address (or home address, if preferred); Telephone; Fax; Email.

18. How long have you known the candidate, and in what capacity.

NOTE: The IEEE Awards Board reserves the right to consider any nomination for Institute Awards other than the award suggested when, in its judgment, the support and justification may more appropriately apply to other Institute Awards.

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