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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
Acadia University
Algonquin College
Assiniboine Community College
BC Institute of Technology
Carleton University
Centennial College
Concordia University
Concordia University College of Alberta
Conestoga College
Dalhousie University
DeVry Institute of Technology - Calgary
École Polytechnique
Fanshawe College
George Brown College of Applied Arts & Technology
Humber College Inst of Tech & Advanced Learning
Kwantlen Polytechnic University
Lakehead University
Laval University
McGill University
McMaster University
Memorial University
Mohawk College of Applied Arts And Technology
New Brunswick Community College
Niagara College
Northern College Of Applied Arts And Technology
Okanagan College
Queen's University
RCC Institute Of Technology
Red River College
Royal Military College
Ryerson Poly University
Saint Lawrence College Of Applied Arts & Technology
Saint Clair College
Saskatchewan Polytechnic
Sault College Of Applied Arts & Technology
Seneca College
Simon Fraser University
Sir Sandford Fleming College
University of Alberta
University of British Columbia
University of Calgary
University of Guelph
University of Northern British Columbia
University of British Columbia - Okanaga
University of Manitoba
Université de Moncton
University of New Brunswick
University of Ottawa
UQ à Chicoutimi
UQ à ETS Montréal
UQ à Montréal
University of Ontario Institiute of Technology
University of Regina
University of Toronto
UQ à Trois-Rivières
University of Saskatchewan
University de Sherbrooke
University of Victoria
University of Waterloo A
University of Waterloo B
University Western Ontario
University of Windsor
York University
(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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