Officer Confirmation Report
For Sections, Subsections, Councils, Chapters, Affinity Groups

To assist the Regional Activities Department in an effort to maintain the most up-to-date officer records, please complete this form when reporting newly elected or current officers and forward to:

IEEE REGIONAL ACTIVITIES
445 Hoes Lane
P.O. Box 1331
Piscataway, NJ 08855-1331, USA
FAX: + 1 732 463 9359

The Officer Confirmation form is used to report officers of the IEEE Geographic Units: Sections, Subsections, Councils, Chapters and/or Affinity Groups. Please specify the entity for which you report. Any questions should be directed to IEEE Regional Activities Department at +1 732 562 5513.

Prepared By________________________________________ Title_________________________
Section/Subsection/Council/Chapter___________________________ Geocode_______________
Officers' Terms End Date____________________________________________

QUALIFICATIONS to HOLD OFFICE are as follows:

a) Current IEEE Membership

b) Membership grade must be Life Fellow, Fellow, Life Senior Member, Senior Member, Life Member, or Member

c) Membership in Geographic Unit in which office is to be held (Section or Council)

d) Chapter Officers must be CURRENT members of the Society in which they hold office, as well as  being current members of IEEE. In the case of JOINT CHAPTERS, membership in any (1) of the Societies is sufficient.

Please note the following:

  1. If a newly elected officer does not meet eligibility requirements or if officers are not reported, the position will be listed as vacant until reporting of an eligible officer is received.

  2. Contact information provided (telephone, fax number, email, etc) will become a part of the officer's record and will appear in the Geographical Organization Roster.  Always use IEEE email aliases when available.

  3. Please include member numbers.

  4. Any additional information may be included if pertinent. Attach additional pages if necessary.

  5. Remember to make a copy for your records in order to verify your Officer Confirmation copy against the most recent Geographical Organization Roster.

  6. You may wish to provide a copy of your officer reporting to your Region Secretary and Newsletter Editor.

  7. Please forward this form to the incoming Secretary (or responsible officer) if the current term is near expiration.

  8. The names of newly elected officers shall be reported to IEEE Headquarters within 20 days following the election.

SECTION / SUBSECTION / COUNCIL OFFICERS

Please include country code, area code and/or city code for  telephone and fax numbers.  Remember, positions left blank will be listed as "vacant" in the officer roster.  Former officers will not be carried over unless specified.

ENTITY NAME:_______________________________________________________________
ENTITY EMAIL:_______________________________________________________________
 
Please use IEEE email aliases whenever available
 
CHAIR
NAME:______________________________________MEMBER#:___________________________________
WORK:_____________________________________HOME:_______________________________________
FAX:________________________________________EMAIL:___________________________________
 
VICE CHAIR
NAME:______________________________________MEMBER#:___________________________________
WORK:______________________________________HOME:______________________________________
FAX:________________________________________EMAIL:___________________________________
 
SECRETARY
NAME:______________________________________MEMBER#____________________________________
WORK:______________________________________HOME:______________________________________
FAX:________________________________________EMAIL:___________________________________
 
TREASURER
NAME:______________________________________MEMBER#:___________________________________
WORK:______________________________________HOME:______________________________________
FAX:________________________________________EMAIL:___________________________________
 
SECRETARY/TREASURER
NAME:______________________________________MEMBER#:___________________________________
WORK:_____________________________________HOME:_______________________________________
FAX:________________________________________EMAIL:___________________________________
 
Please use IEEE email aliases whenever available
 
MEMBERSHIP DEVELOPMENT
NAME:______________________________________MEMBER#:___________________________________
WORK:______________________________________HOME:______________________________________
FAX:________________________________________EMAIL:___________________________________
 
PROFESSIONAL ACTIVITIES
NAME:_______________________________________MEMBER#___________________________________
WORK:_______________________________________HOME:_____________________________________
FAX:_________________________________________EMAIL:___________________________________
 
STUDENT ACTIVITIES
NAME:________________________________________MEMBER#:_________________________________
WORK:________________________________________HOME:_____________________________________
FAX:__________________________________________EMAIL:___________________________________
 
EDUCATIONAL ACTIVITIES
NAME:________________________________________MEMBER#:_________________________________
WORK:________________________________________HOME:_____________________________________
FAX:__________________________________________EMAIL:___________________________________
 
NEWSLETTER EDITOR
NAME:________________________________________MEMBER#:_________________________________
WORK:________________________________________HOME:_____________________________________
FAX:__________________________________________EMAIL:___________________________________
 
AWARDS
NAME:_________________________________________MEMBER#:________________________________
WORK:_________________________________________HOME:____________________________________
FAX:___________________________________________EMAIL:___________________________________
 
PLEASE INCLUDE THE MEMBER NUMBERS. THEY ARE
REQUIRED TO UPDATE YOUR ENTITY'S RECORDS!
 
ADDITIONAL OFFICERS (PLEASE SPECIFY)   
(attach additional pages if necessary)
 
OFFICE:  ______________________________________
NAME:_________________________________________MEMBER#:_________________________________
WORK:_________________________________________HOME:____________________________________
FAX:___________________________________________EMAIL:___________________________________  
 
OFFICE: _______________________________________
NAME:__________________________________________MEMBER#:________________________________
WORK:__________________________________________HOME:___________________________________
FAX:____________________________________________EMAIL:___________________________________
 

TIMELY REPORTING IS ESSENTIAL FOR ACCURATE OFFICER RECORDS!

CHAPTER and/or AFFINITY GROUP CHAIRS

Please provide the CHAIR for each of your entity's Chapters and/or Affinity Groups. Specify the name of the Society / Chapter / Affinity Group in the space provided. 

Please use IEEE email aliases whenever available
 
CHAPTER / AFFINITY GROUP________________________________
NAME:__________________________________________MEMBER#:________________________________
WORK:_________________________________________HOME:____________________________________
FAX:___________________________________________EMAIL:___________________________________
 
CHAPTER / AFFINITY GROUP ________________________________
NAME:__________________________________________MEMBER#:________________________________
WORK:_________________________________________HOME:____________________________________
FAX:___________________________________________EMAIL:___________________________________
 
CHAPTER / AFFINITY GROUP ________________________________
NAME:__________________________________________MEMBER#:________________________________
WORK:__________________________________________HOME:___________________________________
FAX:____________________________________________EMAIL:___________________________________
 
CHAPTER / AFFINITY GROUP ________________________________
NAME:__________________________________________MEMBER#:________________________________
WORK:__________________________________________HOME:___________________________________
FAX:____________________________________________EMAIL:___________________________________
 
CHAPTER / AFFINITY GROUP ________________________________
NAME:__________________________________________MEMBER#:________________________________
WORK:__________________________________________HOME:____________________________________
FAX:____________________________________________EMAIL:___________________________________
 
CHAPTER / AFFINITY GROUP ________________________________
NAME:___________________________________________MEMBER#:________________________________
WORK:___________________________________________HOME:___________________________________
FAX:_____________________________________________EMAIL:___________________________________

NOTE: Only Chairs of Chapters and Affinity Groups are reported in the Geographical Organization Roster. If you choose to report additional officers, please attach pages as needed.