2019 EMBS Distinguished Lecture Request/Approval

Requested Distinguished Lecturer:*

Event Name:*

Date:*

Location:*

IEEE Region:*

What TC does this represent:*

Host Contact Name:*

Host Contact Email:*

Hosting Chapter:*

Number of EMBS Chapter Members:*

Number of Expected Attendees:*

How will this benefit the chapter members?*
i.e., nature of the event, is it part of a larger conference, etc.

Amount of funding requested?*
EMBS can match 2:1 up to $1000 USD

Source of matching funding:*
Where else was the money raised?

What will the funding be used for?*
travel, housing, etc

Documentation of Matching Funding*
Please attahced letter stating that other funds were raised

Send me a copy of my responses

Email address