WG Awards

1. IEEE Standard Number:*

e.g XXXX(Standard number)- XXXX (Year)

2. Approval Date:*

Select the IEEE-SA Program Manager :*

3. Will all the Awards be sent to an event?*

Yes
No

3 A . Provide the recipients's full name responsible for award collection:

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Working Group Officers- Plaques

The IEEE-SA presents plaques to working group officers in recognition of their contribution to the development and publication of a standard.

4. Plaques for Working Group Officers:*

A) Working Group Chair
B) Working Group Vice Chair
C) Working Group Task Force Chair(s)
D) Technical Editor
E) Secretary
F) Treasurer
G) N/A

Name of the Working Group Chair ( As it should display on the award)*

Address ( Unable to deliver to PO Box Address)*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of the Working Group Vice Chair ( As it should display on the award)*

Address ( Unable to deliver to PO Box Address)*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of the Working Group Task Force Chair (s) ( As it should display on the award)

Address ( Unable to deliver to PO Box Address)*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of the Technical Editor ( As it should display on the award)*

Address ( Unable to deliver to PO Box Address)*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of the Secretary ( As it should display on the award)*

Address ( Unable to deliver to PO Box Address)*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Name of the Treasurer ( As it should display on the award)*

Address ( Unable to deliver to PO Box Address)*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Certificates

The IEEE-SA presents certificates to working group participants in recognition of their contribution to the development and publication of a standard.

5. Will you be awarding certificates to your Working Group participants?*

Yes
No

If you would like to include a special reason(s) for the certificate, then please list it here:

5 A. File Upload or Manual Entry of Recipients*

Manually Enter Recipients
Upload File

Please indicate if you would like to upload a spreadsheet or manually enter the recipients.

Complete Name (As it should display on Award)	Address (Physical Address of where to Mail Award)

Note: XLS, CSV XLSX, are available for upload ONLY.* Indicate the address and do not include a P.O Box address.

Download Name and Address Award Template Here

File

Note: XLS, CSV XLSX, are available for upload ONLY.* Indicate the address and do not include a P.O Box address.

Submitter Information:

Name:*

Email*

Enter Email Confirm Email

What is your role in the Working Group?*

Comment Box

Please provide any additional information regarding your submission. If you have requested your order to be mailed for an event, please indicate the dates of the event and when the shipment should arrive.

Please allow 6 -- 8 weeks for awards to ship.

Working Group Awards

Working Group Officers- Plaques

Certificates

Submitter Information: