Friend of IEEE Member and Geographic Activities Award Nomination Form

Before completing the nomination form, please review the Friend of IEEE MGA Award guidelines. Reference the previous Friend Award recipients for examples of recognized support and citations.

Please follow all instructions carefully when completing the nomination form.

* All Fields are Required *

Please select one Award

Individual - Supporting Friend Award

Organizational - Supporting Friend Award

Individual - Sustaining Friend Award

Organizational - Sustaining Friend Award

To be nominated for a Supporting Friend Award, the candidate should have a long (minimum one full year) history providing support to the IEEE. Specific examples of support are required. Generalized and unsupported statements will not be sufficient. Supporting Friend awards may be made for truly extraordinary examples of singular events, for example, assistance provided to host and IEEE conference or meeting.

To be nominated for a Sustained Friend Award, the candidate or organization should have a long (minimum of three years) history of demonstrating their support to Member and Geographic Activities (MGA). The candidate or organization must have won a Supporting Award at least once during this period. Sustaining Friend awards are not given for singular events.

Nominee Information

Nominee Name
Primary Contact (if organization)

Address

City State/Prov
Postal Code

Country

Telephone Number
E-mail Address

Achievements and Accomplishments

How long has the individual/organization provided service to MGA?

How has the individual/organization supported MGA?

The award should consist of (select one) Plaque Certificate

Suggested Citation. The "Suggested Citation" of what will appear on the plaque or certificate awarded to the recipient(s). The citation should reflect the award criteria and the nominee's support.

Endorsements

Nominations should be endorsed by an appropriate number of IEEE members to indicate that the support provided is genuine and broadly based.

Name
Member Number

Nominator Information

Nominator Name
Member Number

Address

City State/Prov
Postal Code

Country

Telephone Number

E-mail Address

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