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Student Declaration for an
IEEE Canadian Foundation Scholarship
Instructions to complete this form:
The student nominee is to complete all sections of this form and submit electronically.
The nominee must be
a student member of IEEE,
in a Canadian IEEE student branch with an active IEEE McNaughton Learning Resource Centre,
registered in his or her penultimate undergraduate year,
and have been active in the Centre for a minimum of one year.
It is recommended to prepare this declaration using a word processor or editor and keep a copy for any future use.
Please read the information about nominations for scholarships and operation of McNaughton Centres available on this
web site
.
You will not be able to submit this form unless you complete ALL sections..
Step 1: Please identify yourself and your student branch
1.1 Enter your full name (surname last)
1.2 Enter your e-mail address
1.3 Enter your student ID number (as assigned by your institution)
1.4 Select your university or college from this list:
Select your University or College
Carleton University
Concordia University
Dalhousie University
École Polytechnique - Montréal
Laval University
McGill University
McMaster University
Memorial University
Queen's University
Royal Military College
Ryerson University
University of Alberta
University of British Columbia
University of British Columbia - Okanagan
University of Calgary
University of Guelph
University of Manitoba
University of New Brunswick
University of Ottawa
Université du Québec - Trois-Rivières
University of Regina
University of Saskatchewan
Université de Sherbrooke
University of Toronto
University of Victoria
University of Waterloo A
University of Waterloo B
University Western Ontario
Algonquin College
Conestoga College
Niagara College
Red River College
Saint Clair College
Seneca College
(if your university or college is not on this list, it means you do not have a McNaughton Centre and are not eligible for this Scholarship)
1.5 Enter your IEEE membership number
1.6 Enter your position on your IEEE student branch executive
1.7 Enter the full name (surname last) of your branch counselor who must complete and submit the on-line nomination form.
1.8 Enter your branch counselor e-mail address
(this address will be used to send a copy of your submission to your branch counselor)
Step 2: Please provide information about your branch and centre
before continuing, check the information on the foundation web site. If any of the information is incorrect, please use the
update form
to send corrections (or have someone else do this before you submit this form.
2.1 Please confirm that your student branch has updated its contact details displayed on the IEEE Canadian Foundation web site.
Correct
Correction sent
Incorrect
2.2 Please confirm that the entrance to your centre is clearly signed as:
IEEE McNaughton Learning Resource Centre at (School Name)
Sponsored by the IEEE Canadian Foundation
Correct
Incorrect
2.3 Please confirm that your centre has the framed photograph of General McNaughton prominently displayed.
This photograph was provided at the formal opening of your centre
Correct
Incorrect
2.4 Please confirm that your student branch has a web site and at least one web page describing your McNaughton Centre and that both URLs are linked from the IEEE Canadian Foundation web site.
Correct
Incorrect
Step 3: Please tell us about your involvement with your Centre and Branch
WARNING: "When you cut and paste into the following text boxes, the text will be truncated to the maximum allowed"
3.1 Check the number of years have you been an IEEE member round up - use 1 for half year etc.)
4 ,
3 ,
2 ,
1 ,
0
3.2 Tell us what Centre Committees you have served on or chaired, and state your most important contributions
Number of Characters =
0
of 900
3.3 Tell us about other Centre activities you have been involved in
Number of Characters =
0
of 900
3.4 Give us the best example where you demonstrated leadership in your Centre
Number of Characters =
0
of 900
3.5 Describe how the Centre has enabled and contributed to your activities
Number of Characters =
0
of 900
3.6 Tell us what Branch activities, committees served on or chaired, and state your most important contributions
Number of Characters =
0
of 900
3.7 Tell us what you want to accomplish for and with your Centre as a scholarship holder
Number of Characters =
0
of 900
 Step 4: Submit your Declaration.
Note 1: your branch counselor should automatically receive a copy of this declaration form output.
Note 2: make sure that your branch counselor submits the nomination form on your behalf.
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feedback welcome