Nomination Form for Distinguished Lecturer Volunteers, SPCC TC

Nomination Form for Distinguished Lecturer Volunteers, SPCC TC

To Volunteer to be appointed as Distinguished Lecturer (DL) on behalf of the SPCC TC (self-nominations are welcome), please fill in the following fields.
Name

First NameLast Name
Affiliation
Address

Department / Unit

Street Address

City / TownState / Province

Postal / Zip CodeCountry
Email
example@example.com
Web
Phone Number
Please enter a valid phone number.
IEEE Number
IEEE Status (Senior Member, Fellow, etc)
YesNo
Please specify your region within IEEE regions:
Gender
Professional sector
Please specify your leadership positions
Please specify your awards and recognitions
Please specify your invited presentations, tutorials, keynotes, etc.
Please specify the subjects/topics of possible DL talks
YesNo
Please detail your activities and contributions to the SPCC TC:
Please attach your curriculum vitae here:

Cancelof
Please provide your video link (Optional):
Thank you for volunteering. We will get in touch with you when any opportunity comes.
Should be Empty:

Thank you for volunteering. We will get in touch with you when any opportunity comes.