The 2016 Region 6 Awards Nomination Form

This new and simplified form shall be used for all Region 6 awards in every Section.

The Region 6 awards process begins with your submission of this document to your Section’s Awards Chair. If your Section does not have an Awards Chair, then submit this to the Section Chair.Per IEEE rules, no nominations for individual awards will be accepted that are self-nominated.

Before you begin, please read the documents explaining each awards category in detail and examples.

The due date is May 13, 2016 at 11pm your local time.Do not wait until the last minute! Finish your nominations sufficiently far in advance of the due date to allow for review and revisions if necessary.

If the Nominee is an award winner in your Section, this nomination document will be sent to the Area Awards Chair. Please keep this in Wordcompatible format to allow edits and revisions.

Information section 1

Origin and Nominator Information
What is the name of your Section?
What is the name of your city and state?
Who is your Awards Chair (or Section Chair if there is no Awards Chair)?
The email address of your Section Awards Chair or Section Chair:
What is the name of your Area of Region 6?
What is your name (Nominator)?
What is your IEEE member number and level?
Nominator’s email address:
Nominator’s cellphone number:
Nominator’s work number:
Nominator’s home number:

Information section 2

Nominee Information (specify category)
Are you nominating (place an X after the correct selection)
  • an individual?
  • an Organizational Unit (OU) such as Chapter, Student Branch, Section, or other?
  • a Company or Corporation?

If you are nominating an individual, please go to Information section 3
If you are nominating an OU (Chapter, Student Branch, Section, or other), please go to Information section 4
If you are nominating a company or corporation, please go to Information section 5

Information section 3

Nominee Information for an Individual
Which award are you nominating this person for? Place an X before the correct category
___ Outstanding Engineer
___ Outstanding Leadership and Professional Service
___ Outstanding Engineering Manager
___ Outstanding Educator
What is the Nominee’s name?
What is the Nominee’s IEEE member number and level? Educator is the exception. They do not need to be an IEEE member.
Nominee’s email address:
Nominee’s cellphone number:
Nominee’s work number:
Nominee’s home number:
Nominee’s mailing address in case the award needs to be mailed:
Now go to Information section 6

Information section 4

Nominee Information for an OU (IEEE Organizational Unit)
Special instructions for nominating an OU
An OU that wins a Section award must skip a year after winning before applying again for the same award
Which award are you nominating this OU for? Place an X before the correct category
___ Outstanding Chapter
___ Outstanding Small Student Branch (<26 Active IEEE Members as of April 30, 2016)
___ Outstanding Large Student Branch (26 or more Active IEEE Members as of April 30, 2016)
___ Outstanding Small Section (<501 Active IEEE Members as of April 30, 2016)
___ Outstanding Large Section (501 or more Active IEEE Members as of April 30, 2016)
___ Outstanding other type of OU not described above
What is the name of the OU?
Whois the Chair of this OU?
Chair’s email address:
Chair’s cellphone number:
Chair’s work number:
If it is a Student Branch, who is the faculty advisor and email address?
Now go to Information section 6

Information section 5

Nominee Information for a company or corporation
Special instructions for nominating a company
A company or corporation that wins a Section award must skip a year after winning before being nominated again.
What is the name of the company or corporation?
Who is / are specific people in this company that are IEEE members and can officially represent this company if they win this award?
Name 1:
department:
email address:
work phone number:
cellphone number:
Name 2 (if applicable):
department:
email address:
work phone number:
cellphone number:
Actual address of the company:
Name of an Executive who can be notified if this company wins an award:
Contact information:
Now go to Information section 6

Information section 6

Why is this individual / OU / company being nominated?
State why this Nominee (individual / OU / company) deserves recognition. Keep in mind the purpose and description of the award. Thoroughly and clearly state the individual’s / OU’s / company’s contributions and accomplishments. If this is for an OU, show how your Branch, Chapter, or Section compared to previous years. A separate instruction document will be provided with details about each award category and with examples of previous winning nominations. Note that brevity is not your friend.
Type as much as you need in this box and please add additional pages. You can attach a resume, biography, CV, photos, charts, figures, and webpage screenshots as appropriate. They must be attached within this Word compatible doc or docx file. Again, please no PDFs and no separate files.
To the Nominator: is there a specific thing that made you want to nominate this person or group?
For Individual Nominees: what IEEE positions and other responsibilities has the nominee had in the last five+ years that relate to this nomination? You may use additional pages. The Educator award is an exception as they do not need to be an IEEE member.

Information section 7

Final Information
Citation that should appear on the award (if won). This should be no more than 50 words and start with “For …...”
Summarize the significance of the awardees accomplishments that resulted in being the award recipient. It is best to make this brief because it will become several lines of engraved text on the plaque.
Awards Chairs: please add dates and notes if you revise or correct this nomination package.