FRED NATHANSON MEMORIAL RADAR AWARD NOMINATION FORM
(SUBMIT BY JANUARY 31 of the nomination year)
THE INSTITUTE OF ELECTRICAL AND ELECTRONICS ENGINEERS, INC.
Email an electronic copy of all forms to: sdblunt@ittc.ku.edu
Mail hardcopies of completed Nomination & Reference forms in one envelope to:
Nathanson Awards Chair, Prof. Shannon Blunt, University of Kansas – EECS Dept., 1520 W. 15th St., Lawrence, KS, 66045-7608 (USA)
1. NAME OF CANDIDATE _________________________________________________________________________________________
LAST, First, Middle
PRESENT OCCUPATION________________________________________________________________________________________________
Position
PREFERRED MAILING ADDRESS
MAILING ADDRESS
Organization
Business
Home
IEEE MEMBER: _____Yes
_____No
__________________________________________________________________________________________
This Form and Confidential References Must be Received by January 31 of the nomination year.
_______________________________________________________________________________________________________________________
City/State/Province
Country
BIRTHDATE_____________________________
IEEE MEMBER GRADE & NO.___________________________________________
TELEPHONE________________________________
FAX__________________________
EMAIL______________________________
Location
Degrees
2. EDUCATION
Educational Institution
3.
Zip/Postal Code
Year
PROFESSIONAL HISTORY. Current position first. LIMIT COPY TO SPACE PROVIDED; if necessary, cite only most recent positions.
From (year) to (year)
Name of Employer
Position Held and Responsibilities
4. NOMINATOR:
__________________________________________________________________________________
______________________________
NAME
(Signature)
DATE
__________________________________________________________________________________
IEEE MEMBER: ____Yes ____No
NAME (Prof./Dr./Mr./Mrs.)
(Print)
____________________________________________________________________________________________________________________
ADDRESS
____________________________________________________________________________________________________________________
_____________________________
TELEPHONE
__________________________________
FAX
_______________________________________
EMAIL
DATE_____________________________________________________________________________________
NAME OF CANDIDATE_____________________________________________________________________
5. EVIDENCE OF TECHNICAL ACCOMPLISHMENTS IN THE FIELD OF RADAR.
6. FRED NATHANSON MEMORIAL RADAR AWARD REFERENCES. List alphabetically the complete names of a minimum of 3
(maximum of 5) references.
1.
2.
3.
4.
5.