IEEE REGIONAL ACTIVITIES
THE INSTITUTE OF ELECTRICAL AND ELECTRONICS ENGINEERS, INC.
445 HOES LANE, P.O. BOX 1331, PISCATAWAY, NJ 08855-1331 U.S.A.
(Vox) 908-562-5501; (Fax) 908-463-3657; (Email) email@example.com
REQUIREMENTS FOR FORMING A STUDENT BRANCH CHAPTER OF AN IEEE SOCIETY
1. A petition signed by not less than six (6) Branch members, who are members of the Society, must be submitted to IEEE Student Services.
2. The Petition must specify the name of the Branch, the name of the Society with which the Branch chapter will be affiliated, the name of the interim Chairman, and the name of the faculty Advisor, who is also a member of the Society.
3. After the Advisor and the Student Branch Executive Committee have approved the petition, it will be mailed to IEEE Student Services.
4. If the petition is in order, Student Services will take the necessary action to obtain formal approval of the petition by the Regional Director, the Regional Student Activities Committee Chair, and the Society President.
5. Send petition to:
IEEE Student Services Manager
445 Hoes Lane
PO Box 1331
Piscataway, NJ 08855-1331
PETITION FOR THE ESTABLISHMENT OF AN IEEE SOCIETY STUDENT BRANCH CHAPTER
Name of IEEE Society:
Name of IEEE Student Branch:
We, the undersigned, who are members of the above named Society and IEEE Student Branch, hereby petition for approval to form a Branch Chapter of the Branch indicated above. We agree to adopt and conform to the recommended Constitution previously approved for the IEEE Student Branch.
Signature/IEEE Member Number*/ Printed Name
(Interim Branch Chapter Chairman)
*If a petitioner is a new member of the IEEE and has not yet had a membership number assigned, please give the date the application was mailed as well as the Zip Code (if U.S.) or City, Country to which IEEE was instructed to send mail.
|This action has the approval of the Student Branch Executive Committee||The following individual is serving as the Branch Chapter Advisor, who is a member of both the IEEE and the designated Society.|
Branch Counselor Signature:
Branch Chapter Advisor Signature: