R1 Award Nomination Form IEEE R1 Nomination Form Step 1 of 3 33% Nominee InformationIs the Nominee a Region 1 Board Member or the Section Chair?Region 1 Board memberSection ChairSection IEEE MemberNominee Name First Last Section*Select SectionBerkshireBinghamtonBostonBuffaloConnecticutGreen MountainIthacaLong IslandMaineMid-HudsonMohawk ValleyNew HampshireNew Jersey CoastNew YorkNorth JerseyPrinceton/Central JerseyProvidenceRochesterSchenectadySpringfieldSyracuseWorcester CountyPhoneEmail IEEE NumberAddress Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code AwardAward Category*ProfessionalLifetime ServiceProfessional Subcategories3A - Technological Innovation (Academic) For distinguished development, advancement and pursuit of the IEEE’s Technical Objectives3B - Technological Innovation (Industry or Government) For significant Patents, for discovery of new devices, development of applications or exemplary contributions to industry or government3C - Managerial Excellence in an Engineering Organization For managerial excellence in organization, leadership, design and development3D - Outstanding Teaching in an IEEE area of interest (University or College) For outstanding contributions to Education in an area of interest to the IEEE3E - Outstanding Teaching in an IEEE Area of interest (Pre-University or College) For improving communications between the IEEE and a student body; for support and service to a student body; for service and leadership to the student community3F - Enhancement of the relationship between IEEE and Industry For significant contributions in an enhanced IEEE-INDUSTRY relationship3G - Enhancement of the IEEE or Engineering Profession’s Image with the Public For significant contributions in developing IEEE-PUBLIC relationship3H – Outstanding Support for the Mission of the IEEE, MGA, REGION 1 and Section For outstanding Service to the IEEE at Chapter, Section, Region, RAB or National levelLifetime Service Award4A - The William Terry Distinguished Service Award This award is intended to recognize those whose personal efforts have provided leadership, creativity, guidance, hard work and inspiration in a wide range of IEEE activities over a long period of time.Suggested wording for the citationContribution SummaryEnter, in less than 200 words, a summary of the contribution(s) that you believe warrants this nomination specific to the award.ExperienceIEEE and Job related experience (Biography) related to award, in less than 1 page. NominatorAre you the Section Chair?YesNoAre you the Section Vice Chair?YesNoIf the Section does not have a VC, check yes if you are the Section Secretary or Treasurer.Are you the Region 1 Director or Director-Elect?YesNoNominator Name First Last Section*Select SectionBerkshireBinghamtonBostonBuffaloConnecticutGreen MountainIthacaLong IslandMaineMid-HudsonMohawk ValleyNew HampshireNew Jersey CoastNew YorkNorth JerseyPrinceton/Central JerseyProvidenceRochesterSchenectadySpringfieldSyracuseWorcester CountyPhoneEmail IEEE NumberPlease enter a number greater than or equal to 0.Address Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code UntitledFirst ChoiceSecond ChoiceThird Choice
