2023 EDS Mini Colloquia Request Form

2023 EDS Mini Colloquia Request Form

*Please note that this form can only be completed by IEEE EDS Chapter Officers

Form Submitted by EDS Chapter Chair Name*

EDS Student Chapter Advisor Name

Chapter Email Address*

MQ Sponsoring Chapter(s)*

Title of Lecture (MQ name)*

Date of Lecture*

Type of Lecture*

Select or enter value

Location of Lecture*

IEEE Region Lecture will be held in*

Did your chp. receive MQ funding in 2022?*

Select or enter value

Did your chapter receive MQ funding in prior years*

Select or enter value

Distinguished Lecture Name(s)*

Total MQ Income (include other MQ sponsors)*

Total MQ Expenses (Include all expenses)*

List EDS DLs and Expenses to be reimbursed*

Total EDS MQ Funding Requested*

Additional Information about the MQ

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