2019 Distinguished Lecturer Claim Form
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, EMBS Student Branch Chapters, and EMBS Student Clubs.
To receive the matching fund reimbursement, complete the Distinguished Lecturer Claim Form along with documentation of matching funds, travel expense receipts and a report of the event. (Or if you prefer, your Distinguished Lecturer may submit a travel expense report and travel receipts directly to the EMB Executive Office for reimbursement directly to the lecturer).
Approved Confirmation Code:
This is the code that was given when the approval was granted
Region 1 (Northeastern U.S.)
Region 2 (Eastern U.S.)
Region 3 (Southern U.S.)
Region 4 (Central U.S.)
Region 5 (Southwestern U.S.)
Region 6 (Western U.S.)
Region 7 (Canada)
Region 8 (Africa, Europe, Middle East)
Region 9 (Latin America)
Region 10 (Asia and Pacific)
Name of Distinguished Lecturer Requested:
Ved Ram Singh
Bart ter Haar Romney
Title of Lecture
Date of Lecture
# of Attendees
Amount of Funding Requested
Name of Hosting Chapter/Club
Name of Chapter/Club Contact
Chapter/Club Contact Email
Which Technical Committee does this represent?
- Biomedical Signal Processing - (BSP)
- Biomedical Imaging and Image Processing - (BIIP)
- Bionanotechnology and BioMEMS - (BNBM)
- Cardiopulmonary Systems - (CPS)
- Wearable Biomedical Sensors and Systems - (WBSS)
- Bio-Robotics - (BR)
- Therapeutic Systems and Technologies - (TST)
- Neuro-Engineering - (NE)
- Computational Biology and the Physiome - (CBP)
- Biomedical and Health Informatics - (BHI)
- Translational Engineering and Healthcare Innovations - (TEHI)
Where are the Funds to be sent?
Chapter have a concentration bank account
Chapter have a bank account
ATTACH THE FOLLOWING
-Proof of Matching Funds Raised By Hosting Organization
-Write-up and Even Recap
Send me a copy of my responses
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