PRESENTATION OF AWARD: The purpose of this award is to recognize IEEE members who have given valuable
service to Portugal Section. A certificate will be awarded to the selected nominee. Presentation of the award will be
arranged by the Section Chair at an appropriate occasion.
Portugal Section Volunteer Award
NOMINATION FORM
Note: this form must be returned to the IEEE Portugal section Awards and Recognition Chair, Paulo Gonçalves
(awards@ieee-pt.org), no later than September 18th 2015.
1.
2.
Information concerning the candidate
a.
General information

Title:

Full name:

Address (long term):

Telephone:

E-mail address:
b.
Candidate's Offices and assignments in the Section:
c.
Non-IEEE activities considered of benefit for the Section
d.
Candidate's special contribution to the Section (explain why the candidate should be
recognized for the Award)
e.
Position held in present employment
Information concerning the proposer
a.
General information

Title:

Full name:

Address (long term):

Telephone:

E-mail address:
b.
Proposer's present and/or past functions in the Section and in the IEEE generally (if any):
Name and Title:
Date:
Signature:
IEEE Portugal Section Best Volunteer Award Nomination Form – page 1 of 1