photonics by ashrafp

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									                                            NOMINATION FORM FOR
                                           IEEE PHOTONICS AWARD

              For outstanding achievements in Photonics. To an individual or team up to three.
                          (See Nominator Guidelines for Eligibility Requirements.)

1. Name

2. IEEE Member: Yes         No ___      IEEE Grade, Year           IEEE Member #

3. Year of Birth

4. Professional Affiliation and Title

5. Business Address


6. Home Address and Email


7. Education beyond twelfth grade. Honorary degrees denoted (H).

     Institution/Location                              Degree        Year            Honors



8. Endorsers, Names, Addresses, and 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.)




 Do not exceed 4 pages. Attached pages are not permitted. Type no smaller than 10 point.                Page 1 of 4
 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.)




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12. Achievements pertinent to the qualifications for the IEEE Photonics Award. (Criteria considered by the
Evaluation Committee shall include: outstanding discovery, significant scientific or technological advancement or
important invention, and impact on field. The quality of the nomination is also considered.)




(This section should be written in paragraph form and should not exceed one page in length.)




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13. Principal IEEE Activities; Dates, Description.



14. Other Principal Professional Activities; Dates, Description.



15. Principal Honors (non-IEEE)



16. IEEE Honors/Awards



17. Nominator: Name, Business Affiliation and Address (or home address, if preferred); Telephone; Fax; Email.



17a. How long have you known the candidate and in what capacity?



18. Suggested Presentation Location. (Please provide an IEEE-sponsored technical conference or symposium.)



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.

Date:                             Signature: _____________________

Submit to: IEEE Awards Activities, 445 Hoes Lane, Piscataway, NJ 08854
Tel:732.562.3844; Fax:732.981.9019; Email:awards@ieee.org




  Do not exceed 4 pages. Attached pages are not permitted. Type no smaller than 10 point.            Page 4 of 4

								
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