Address line 1: Address line 2: City: State/Province: ... technical conference, symposium, or meeting within the scope o
IEEE Kiyo Tomiyasu Award Nomination View the Nominator Guidelines for instructions to complete the form. Submit by email to
[email protected] by 31 January. Complete questions 1-5 for each candidate (up to three) and questions 6-11 for the team nomination. If selected, co-recipients will be listed in all presentation and publicity materials in the order on the nomination form. * Denotes required field 1. *CANDIDATE INFORMATION. Prefix: Name (First/Given, Middle, Last/Family/Surname): IEEE Member number: IEEE Member grade: Preferred contact information (personal or professional): Email address: Phone: Title: Affiliation: Address line 1: Address line 2: City: State/Province: Postal Code: Country: Date of Birth: (DD Month YYYY) Candidates for the IEEE Kiyo Tomiyasu Award must be within fifteen years of their highest academic degree and not more than age forty-five at the time of the nomination. 2. 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. 3. 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. 4. PRINCIPAL HONORS. Briefly describe the candidate’s four (4) highest honors, including IEEE and non-IEEE recognitions. A. B. C. D. 5. 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. IEEE Kiyo Tomiyasu Award Nomination
Page 1 of 4
B. C. D. E. F. G. H. The remaining questions pertain to the team nominated for this award (if applicable). 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
[email protected]). The nominator cannot be an endorser. View the Nominator Guidelines for complete information. All contact information is required. Personal and professional contact information is acceptable. *A. Prefix: 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: 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: Name (First/Given, Middle, Last/Family/Surname): Email address: Phone: Title: Affiliation: IEEE Kiyo Tomiyasu Award Nomination
Page 2 of 4
Address line 1: City: Postal Code:
Address line 2: State/Province: Country:
D. Prefix: 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: 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: 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: NOTE: The IEEE Awards Board reserves the right to have any nomination submitted for an IEEE-level award be considered for a different IEEE-level award when, in its judgment, the support and justification for the original nomination may be more appropriate for a different IEEE-level award. Submit to:
[email protected] by 31 January Do not exceed word count. Attached pages are not permitted. Type no smaller than 10 point. For inquiries, contact: IEEE Awards Activities, 445 Hoes Lane, Piscataway, NJ 08854-4141 USA Tel: +1 732 562 3844; Fax: +1 732 981 9019; Email:
[email protected]
IEEE Kiyo Tomiyasu Award Nomination
Page 3 of 4
IEEE Kiyo Tomiyasu Award Nomination
Page 4 of 4
