For assistance contact IEEE Regional Activities at:
(Vox) 908-562-5501;
(Fax) 908-463-3657;
(Email)
regional.activities@ieee.org
Requirements for Forming a Student Branch Chapter of an IEEE Society
1. A petition signed by not less than twelve (12) 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:
School Code:
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
1.
(Interim Branch
Chapter Chairman)
2
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
*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:
Date:
Printed Name:
Mailing Address:
Telephone Number:
Fax Number:
Email Address: |
Branch Chapter Advisor Signature:
Date:
Printed Name:
Mailing Address:
Telephone Number:
Fax Number:
Email Address: |