The Engineering Institute Of Canada Honors, Awards & Fellowships Committee Nomination Form printable pdf download

The Engineering Institute Of Canada Honors, Awards & Fellowships Committee Nomination Form

The Engineering Institute of Canada

Honors, Awards & Fellowships Committee

NOMINATION FORM

Nomination: ___________________________________________________________

(ie. Medal name, Honorary Member or Fellow)

Candidate

Name: ________________________________________________

Home Address:

Street_____________________________________________________________

City, Province, Zip:__________________________________________________

Business Address:

Street____________________________________________________________

City, Province, Zip__________________________________________________

Telephone: ______________________ Res: ___________________________

Fax:

_______________________E-Mail: ________________________

(Note:

As a minimum have either the home OR work address complete.)

Check List:

Attachments:

- Resumé - enclosed

- Nomination Letter - enclosed

- 2 Letters of Support – enclosed

(2 letters should be by Fellows of EIC if possible)

Nominator:

Name: ___________________________________

Address

Street____________________________________________________________

City, Province, Zip__________________________________________________

Telephone: ______________________ Res: ___________________________

Fax:

_______________________E-Mail: ________________________

Member Society: ______________________________________

Signature: _____________________________________________

Date: ______________________

N.B.

Your signature means you have read the resumé, compared it to the criteria for the

Medal, Award or Fellowship. If not sure, include a memo to the EIC HAF Chair explaining your

incertitude and ask for help!

Signature of Society Member of HAF Committee: _____________________________________

The Engineering Institute Of Canada Honors, Awards & Fellowships Committee Nomination Form