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					   IEEE Technical Field Award Nomination – Collaborative Team (2 persons)
View the Nominator Guidelines for instructions to complete the form. Submit by email
to awards@ieee.org by 31 January. Complete questions 1-5 for each candidate
(Candidates A and B) and questions 6-11 for the team nomination.

* Denotes required field.

*AWARD NAME: Click to select an award.
Visit www.ieee.org/awards for a complete list of all IEEE Technical Field Awards,
scopes, and criteria for judging.

   1a. *CANDIDATE A INFORMATION.
      Prefix: Choose an item.
      Name (First/Given, Middle, Last/Family/Surname):
      IEEE Member number:             IEEE Member grade: Select Member Grade.
      Email address:           Phone:
      Title:        Affiliation:
      Address line 1:            Address line 2:
      City:        State/Province:            Postal Code:      Country:

   2a. HIGHER EDUCATION. List degrees. Honorary degrees denoted (H). Limit
      four (4). Include the institution/location, degree, year conferred, and any
      honors.
      A.
      B.
      C.
      D.

   3a. PRINCIPAL EMPLOYMENT. Include years, name of employer, title, and a
      one-sentence description of most recent responsibility. List most recent
      position first. Limit four (4).
      A.
      B.
      C.
      D.

   4a. PRINCIPAL HONORS. Briefly describe the candidate’s four (4) highest
      honors, including IEEE and non-IEEE recognitions.
      A.
      B.
      C.
      D.

   5a. MOST SIGNIFICANT PUBLICATIONS, PROGRAMS, PRODUCTS, AND
      PATENTS. Maximum of eight (8) evidences of accomplishment that are most
      relevant to this nomination. Include the following: name of item, date
      published or announced, name of publication or event, and/or patent number.
      A.
      B.
      C.
      D.
Standard IEEE TFA nomination – Collaborative Team (2 persons)              Page 1 of 4
       E.
       F.
       G.
       H.

   1b. *CANDIDATE B INFORMATION.
      Prefix: Choose an item.
      Name (First/Given, Middle, Last/Family/Surname):
      IEEE Member number:             IEEE Member grade: Select Member grade.
      Email address:           Phone:
      Title:        Affiliation:
      Address line 1:            Address line 2:
      City:        State/Province:            Postal Code:      Country:

   2b. HIGHER EDUCATION. List degrees. Honorary degrees denoted (H). Limit
      four (4). Include the institution/location, degree, year conferred, and any
      honors.
      A.
      B.
      C.
      D.

   3b. PRINCIPAL EMPLOYMENT. Include years, name of employer, title, and a
      one-sentence description of most recent responsibility. List most recent
      position first. Limit four (4).
      A.
      B.
      C.
      D.

   4b. PRINCIPAL HONORS. Briefly describe the candidate’s four (4) highest
      honors including IEEE and non-IEEE recognitions.
      A.
      B.
      C.
      D.

   5b. MOST SIGNIFICANT PUBLICATIONS, PROGRAMS, PRODUCTS, AND
      PATENTS. Maximum of eight (8) evidences of accomplishment that are most
      relevant to this nomination. Include the following: name of item, date
      published or announced, name of publication or event, and/or patent number.
      A.
      B.
      C.
      D.
      E.
      F.
      G.
      H.



Standard IEEE TFA nomination – Collaborative Team (2 persons)           Page 2 of 4
The remaining questions pertain to the team nominated for this award.

   6. *PROPOSED CITATION. Limit 20 words. View the Nominator Guidelines for
      citation specifications.


   7. *SPECIFIC ACCOMPLISHMENTS ASSOCIATED WITH THIS NOMINATION
      AND CITATION. Limited to 5000 characters (approximately 600 words).


   8. *ECONOMIC, TECHNICAL, PROFESSIONAL, OR SOCIETAL IMPACT OF
      CONTRIBUTIONS. This section is heavily weighted in the committee’s
      evaluation of the candidate(s). Limited to 3000 characters (approximately 400
      words).


   9. *ENDORSERS. A minimum of three and a maximum of five endorsement
      letters are required and must be received by the IEEE Awards Department by
      31 January (email awards@ieee.org). The nominator cannot be an endorser.
      View the Nominator Guidelines for complete information. All contact
      information is required.

       *A. Prefix: Choose an item.
       Name (First/Given, Middle, Last/Family/Surname):
       Email address:           Phone:
       Title:        Affiliation:
       Address line 1:            Address line 2:
       City:        State/Province:            Postal Code:     Country:

       *B. Prefix: Choose an item.
       Name (First/Given, Middle, Last/Family/Surname):
       Email address:           Phone:
       Title:        Affiliation:
       Address line 1:            Address line 2:
       City:        State/Province:            Postal Code:     Country:

       *C. Prefix: Choose an item.
       Name (First/Given, Middle, Last/Family/Surname):
       Email address:           Phone:
       Title:        Affiliation:
       Address line 1:            Address line 2:
       City:        State/Province:            Postal Code:     Country:

       D. Prefix: Choose an item.
       Name (First/Given, Middle, Last/Family/Surname):
       Email address:           Phone:
       Title:        Affiliation:
       Address line 1:            Address line 2:
       City:        State/Province:            Postal Code:     Country:

       E. Prefix: Choose an item.
Standard IEEE TFA nomination – Collaborative Team (2 persons)              Page 3 of 4
       Name (First/Given, Middle, Last/Family/Surname):
       Email address:           Phone:
       Title:        Affiliation:
       Address line 1:            Address line 2:
       City:        State/Province:            Postal Code:     Country:

   10. *SUGGESTED PRESENTATION LOCATION. Specify one IEEE-sponsored
      technical conference, symposium, or meeting within the scope of the award for
      possible presentation. Include the full name of the conference in addition to
      acronyms where appropriate and the date of the next event.


   11. *NOMINATOR INFORMATION.
      Prefix: Choose an item.
      Name (First/Given, Middle, Last/Family/Surname):
      Email address:           Phone:
      Title:        Affiliation:
      Address line 1:            Address line 2:
      City:        State/Province:            Postal Code:      Country:

Date submitted: Click here to enter a date.

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

Submit to: awards@ieee.org by 31 January
Do not exceed space provided. Attached pages are not permitted. Type no smaller
than 10 point.

For inquiries, contact:
IEEE Awards Activities, 445 Hoes Lane, Piscataway, NJ 08854 USA
Tel: +1 732 562 3844; Fax: +1 732 981 9019; Email: awards@ieee.org




Standard IEEE TFA nomination – Collaborative Team (2 persons)              Page 4 of 4

				
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