Distinguished Lecturer Claim Form & Wrap Up Report

Distinguished Lecturer Claim Form & Wrap Up Report

EMBS has established a Distinguished Lecturer Program with the primary objective being the compilation of a list of distinguished lecturers/speakers from within the EMBS. EMBS funding is available only to EMBS Chapters and EMBS Student Branch Chapters. To receive reimbursement, complete the Distinguished Lecturer Claim Form along with travel expense receipts and a report of the event with pictures. (Or if you prefer, your Distinguished Lecturer may submit a travel expense report and travel receipts directly to the EMB Executive Office via Concur for reimbursement directly to the lecturer).

Date*

Your Name:*

Your Email:*

Name of Hosting Chapter*

IEEE Region:*

Select

Which Technical Committee does this represent?*

Select or enter value

Event Overview:

Name of Distinguished Lecturer Requested:

Title of Lecture*

Date of Lecture*

# of Attendees*

Brief Summary:*

Please provide a brief summary of the event and its objectives.

Was the event successful in meeting its goals?*

Select or enter value

If yes, please explain why.

If no, please describe the challenges faced.

What other events did you have for the lecturer?

Select or enter value

What feedback did you receive from the attendees?

Financial Information

Amount of Funding Requested*

Where are the Funds to be sent?*

Chapter

Distinguished Lecturer

Does the chapter have a concentration bank account*

Yes

Does the Section/Chapter have a bank account*

Yes

ATTACH THE FOLLOWING

Pictures of the event and the lecturer for social media

File Attachments*

Drag and drop files here or

Send me a copy of my responses

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