IEEE Contribution Proposal Form
Please Complete All Items
Date
IEEE Organizational Unit Name
(Donor)
IEEE Staff Contact Name
IEEE Staff Contact Email Address
IEEE Volunteer Contact (if applicable)
IEEE Volunteer Contact Email
Address (if applicable)
IEEE Treasurer Name
IEEE OU Major Board Name
Please complete the details below that describes the proposal
1. Provide the name, location and other pertinent information concerning the grantee
organization*
Use this space to describe the proposed request.
2. Describe the purpose of the proposed contribution and how it relates to IEEE’s
mission. Do not exceed 200 words.
Use this space to describe the objectives.
3. Provide a statement of the reciprocal benefits and deliverables to be enjoyed by
IEEE and the grantee. Do not exceed 300 words.
Use this space to describe the benefits and deliverables.
4. Specify the amount of funding to be contributed.
Use this space to describe the source of funding and how it may impact the IEEE donor
organization.
*If the grantee organization is not a US Section 501(c)(3) tax exempt nonprofit organization, a gift agreement is required. In such cases
where the grantee organization does not have such agreements, the IEEE Development Office may be contacted for assistance.
[[[email address]]]
Note: Contributions of USD25,000 or less require the approval of the Major Board Vice President or President.
Contributions in excess of USD25,000 require the approval of the IEEE Board of Directors.
A copy of the completed form shall be provided to the IEEE Treasurer by the OU for all requests over USD1,000.