Awards Nomination Form

IEEE Malaysia Awards Nomination - Outstanding Chapter/Student Branch

Please fill out this form to nominate for an award.

1. Choose the Award
Choose the Award

Outstanding ChapterOutstanding Student Branch
Please indicate the most significant accomplishment the Chapter/Student Branch achieved in 2017.
Explain why this chapter/student branch deserves the selected award.

2. Chapter/Student Branch Information
Name of Chapter/SB
Chapter/SB Email (if any)
Chapter/SB Facebook
Chapter/SB Twitter
Chapter/SB Website URL
Number of active members in 2017*
as of 31st October 2017
In what ways, and how often, does the Chapter/Student Branch communicate with its members? (i.e. email, section/chapter/student branch/affinity group newsletter, meetings, website, other).

3. Nominator Information - Chapter Chair /SB Counselor
Your Name

First NameLast Name
Your E-mail Address
IEEE Membership Number
Please submit your nomination with the following attachment:

i) Table or chart of the Chapter/Student Branch’s membership for the past 5 years, by calendar year.

ii) Excel template to list all sponsored/co-sponsored activities/programs including regular and administrative meetings.
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IEEE Malaysia Awards Nomination - Outstanding Chapter/Student Branch