IEEE Continuing Education Partners Program Application

Please note that a non-refundable fee of US$500.00 is charged for processing the IEEE Educational Partners Program Application. Provide a credit card number or a Purchase Order number in the area indicated on the form. Alternatively, return this form with your check made payable to: IEEE Educational Activities, 445 Hoes Lane, Piscataway, NJ 08854, attention: Celeste Tores, Business Administrator.



Organization Data

1. Contact Information:

Organization:
Name:
Title:
Address:
Phone:
E-mail:
Fax:
Web site:


2. Background Information: (Please provide a brief overview of your organization, including Mission Statement, Continuing Education Student Body Size, Type of Business -private, proprietorship, or other- Business Highlights, Target Market, and whether you are Global, Domestic, or both.)

3. Which IEEE Field(s) of Interest does this course or program supplement or complement?
Please check all that apply:

Aerospace Antennas & Propagation Broadcast Technology
Circuits & Systems Communications, Telecommunications Components, Packaging & Manufacturing Technology
Computational Intelligence Computer Consumer Electronics
Control Systems Dielectrics & Electrical Insulation Electromagnetic Compatibility
Electron Devices Engineering Management Engineering in Medicine & Biology
Geoscience & Remote Sensing Image & Signal Processing Industrial Electronics
Industry Applications Information Theory Intelligent Transportation Systems
Instrumentation & Measurement Lasers & Electro-Optics Magnetics
Microwave Theory & Techniques Nanotechnology Nuclear & Plasma Sciences
Oceanic Engineering Power Engineering / Power Electronics Product Safety Engineering
Professional Communications Reliability Robotics & Automation
Sensors Signal Processing Social Implications of Technology
Solid-State Circuits SuperConductivity Systems Man & Cybernetics
Ultrasonics, Ferroelectrics & Frequency Control Vehicular Technology Other (please specify below)
All of the Above    

4. Is your institution accredited by a professional credentialing organization?
Yes No

If so, please specify accrediting body:

5. Do you currently have, or have you ever had, a relationship with IEEE?
Yes No

If so, please describe:

 


Instructional Data

1. What type of Courses or Programs do you offer?
Please provide a Web address with navigation instructions for locating the specific offerings you wish to make available through IEEE:
(please provide multiple web addresses if needed)

Web Address(es) :

* Please note that a hard copy of a course catalog may be requested at a later date.

2. How will these offerings be presented? (Please check all that apply)
Online
Traditional (in the classroom)
Blended

3. Are these offerings available in multiple languages? (Please select all that apply)
English
Spanish
Chinese
Other (please list):

4. Can students interact directly with the professor or presenter?
Yes No

If so, please check all that apply:
by Phone
by E-mail
Face-to-Face

5. Identify your primary competitors and describe how your offerings compare and contrast with theirs:

6. Are there supplemental materials (Books, Papers, CDs, Web sites, etc.) for your offerings?
Yes No

If yes, please check all that apply:
Books Papers
CDs Web sites

7. Is there an additional fee for the supplemental materials?
Yes No



Professional Development

In one or two paragraphs, please describe the target audience for your organization’s offer:

Describe how this offering benefits your intended audience:

Does this offering help professionals prepare to meet or maintain a certification or licensure?
Yes No

Specify the type of credit (if any) earned upon completion of this offering:

Degree (Undergraduate) Degree (Graduate) CEUs
University Credits Certificate PDHs

Other:



Partner Commitment

1. As a partner, is your institution willing to discount your offerings to IEEE Members?
Yes No

2. As a partner, would you be willing to share revenues based on a revenue sharing scale?
Yes No



Payment Information

Please select one of the following payment methods (Credit Card, Purchase Order, Check) for processing of the US$500.00 application fee.

Credit Card
If paying by credit card, please provide your phone number so you can be contacted for card information.
Phone number:

Purchase Order
If paying by purchase order, please provide the purchase order number.
Purchase Order Number:

Check
If paying by check, please make it payable to:
IEEE Educational Activities
445 Hoes Lane
Piscataway, NJ 08854
attention: Celeste Torres, Business Administrator

You will receive a written response confirming receipt of your application.  Please note that the application review process can take up to four weeks from the date of receipt of your form.  In the event IEEE agrees to make your program(s)/course(s) available to its membership, you will be asked to complete a Letter of Agreement, the terms of which will be determined and mutually agreed upon through a later discussion.

If you have any questions, please contact the IEEE Educational Partners Program Administrator .

IEEE