To Ieee Fellow Grade References

FRED NATHANSON MEMORIAL RADAR AWARD NOMINATION FORM

(SUBMIT BY JANUARY 31 of the nomination year)

THE INSTITUTE OF ELECTRICAL AND ELECTRONICS ENGINEERS, INC.

Email an electronic copy of all forms to:

Mail hardcopies of completed Nomination & Reference forms in one envelope to:

Nathanson Awards Chair, Prof. Shannon Blunt, University of Kansas – EECS Dept., 1520 W. 15th St., Lawrence, KS, 66045-7608 (USA)

1. NAME OF CANDIDATE ______

LAST, First, Middle

PRESENT OCCUPATION______

Position Organization

PREFERRED MAILING ADDRESS Business Home IEEE MEMBER: _____Yes _____No

MAILING ADDRESS ______

______

City/State/Province Zip/Postal Code Country

BIRTHDATE______IEEE MEMBER GRADE & NO.______

TELEPHONE______FAX______EMAIL______

2. EDUCATION

Educational Institution Location Degrees Year

3. PROFESSIONAL HISTORY. Current position first. LIMIT COPY TO SPACE PROVIDED; if necessary, cite only most recent positions.

From (year) to (year) Name of Employer Position Held and Responsibilities

4. NOMINATOR:

______

NAME (Signature) DATE

______IEEE MEMBER: ____Yes ____No

NAME (Prof./Dr./Mr./Mrs.) (Print)

______

ADDRESS ______

______

TELEPHONE FAX EMAIL

DATE______

NAME OF CANDIDATE______

5. EVIDENCE OF TECHNICAL ACCOMPLISHMENTS IN THE FIELD OF RADAR.

6. FRED NATHANSON MEMORIAL RADAR AWARD REFERENCES. List alphabetically the complete names of a minimum of 3

(maximum of 5) references.