シニア会員昇格申請書の記入例

APPLICATION/NOMINATION FORM FOR SENIOR MEMBER GRADE※すべて英語でご記入ください(Please fill in this form in English).
Applicant’s Name: XXXXXXXXXXXXXXXXXXXXApplicant’s Member Number (required): XXXXXXXX
Mailing Address: Department of XXXXXXXXXXXXXXXXXXXX, Graduate School of Engineering,
XXXXXXXXXXXXXXXXXXXX
City: XXXXXXXXXXState/Province: Aichi
Postal Code: XXXXXXXXXXCountry: Japan
Phone: +81-XXXXXXXXXX
Fax: +81-XXXXXXXXXX
Email: XXXXXXXXXXXXXXXXXXXX
Nominating Section/Society: Nagoya Section
EDUCATIONAL INFORMATIONFirst Professional Degree
School: XXXXXXXXXXXXXXXXXXXXXXXXXCity & Country: XXXXXXXXXX, Japan
Start Date: XXXXX XX, XXXX
Major Course: Computer Engineering
Degree Received: Bachelor of Engineering Date Graduated: XXXXX XX, XXXX
Masters
School: XXXXXXXXXXXXXXXXXXXXXXXXXCity & Country: XXXXXXXXXX, Japan
Start Date: XXXXX XX, XXXX
Major Course: Computer Engineering
Degree Received: Master of Engineering
Date Graduated: XXXXX XX, XXXXDoctorate/PH.D.
School: XXXXXXXXXXXXXXXXXXXXXXXXXCity & Country: XXXXXXXXXX, Japan
Start Date: XXXXX XX, XXXX
Major Course: Electrical and Computer Engineering
Degree Received: Doctor of Engineering
Date Graduated: XXXXX XX, XXXX
Present Occupation
Title or Position: Professor
Company Name: XXXXXXXXXXXXXXXXXXXXXXXXX
Years of Experience: XX
Address: Department of Computer Science, Graduate School of Engineering
City: XXXXXXXXXXState/Province Aichi
Postal Code: XXXXXXXXXXCountry: Japan
Phone: +81- XXXXXXXXXX
Fax: +81- XXXXXXXXXX
Email: XXXXXXXXXXXXXXXXXXXX

シニア会員昇格申請書の記入例
IEEE Designated Fields
IEEE Bylaw I-104.3 set forth the criteria for elevation to Senior Member grade as follows: a candidate shall be anengineer, scientist, educator, technical executive or originator in IEEE-designated fields. Please select theapplicable designated fields below. If your current position is not in one of the IEEE designated fields please
specify it via "Other".
Check all that Apply:[ ] Engineering[ X ] Computer sciences and information technology[ ] Physical sciences[ ] Biological and medical sciences[ ] Mathematics[ ] Technical communications, education, management, law and policy[ ] Other

PROFESSIONAL EXPERIENCE
April 20XX to present: Professor at the Department of XXXXXXXXXXXXXXXXXXXX, Graduate School ofEngineering, XXXXXXXXXXXXXXXXXXXXXXXXX. Research and teaching in University.
April 20XX to March 20XX: Professor at the Department of XXXXXXXXXXXXXXXXXXXX, Graduate School ofEngineering, XXXXXXXXXXXXXXXXXXXXXXXXX. Research and teaching in the University.
April 20XX to March 20XX: Professor at the Department of XXXXXXXXXXXXXXXXXXXX, Graduate School ofEngineering, XXXXXXXXXXXXXXXXXXXXXXXXX. Research and teaching in the University.
August 20XX to March 20XX: Professor at the Department of XXXXXXXXXXXXXXXXXXXX, Faculty ofEngineering, XXXXXXXXXXXXXXXXXXXXXXXXX. Research and teaching in the University.
April. 19XX to July 20XX: Associate Professor at the Department of XXXXXXXXXXXXXXXXXXXX, Faculty ofEngineering, XXXXXXXXXXXXXXXXXXXXXXXXX. Research and teaching in the University.
June 20XX to March 20XX: Visiting Researchers at University of XXXXXXXXXXXXXXXXXXXX underFellowship Program for Japanese Scholars and Researchers to Study Abroad. Research in the University.
Research on XXXXXXXXXXXXXXXXXXXX, XXXXXXXXXXXXXXXXXXXX, and XXXXXXXXXXXXXXXXXXXX.
April 19XX to March 19XX: Researcher at XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX.
Research and development of XXXXXXXXXXXXXXXXXXXXXXXXX, XXXXXXXXXXXXXXXXXXXXXXXXX, andXXXXXXXXXXXXXXXXXXXXXXXXX.
SIGNIFICANT PERFORMANCEHe obtained M.E. and Ph.D. degrees from XXXXXXXXXXXXXXXXXXXXXXXXX, where he was engaged inresearch on XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX in WAN and LAN. He has enlarged his research area
so as to include XXXXXXXXXXXXXXXXXXXX, XXXXXXXXXX and XXXXXXXXXXXXXXXXXXXX after hemoved to XXXXXXXXXXXXXXXXXXXXXXXXX. He has an established reputation as an outstanding researcher
in these fields by his publications in various refereed journals such as the Transactions of IEEE, Springer, IEICE,

シニア会員昇格申請書の記入例
ITE, VRSJ, and many academic meetings. Recently he published his book chapter entitled“XXXXXXXXXXXXXXXXXXXXXXXXX” and his tutorial papers entitled “XXXXXXXXXXXXXXXXXXXXXXXXX”
and “XXXXXXXXXXXXXXXXXXXXXXXXX.” These are recognized as useful book chapter and tutorial paper tolearn XXXXXXXXXXXXXXXXXXXX, XXXXXXXXXX, and XXXXXXXXXXXXXXXXXXXX in Japan.
Based on these noticeable contributions, I strongly recommend that Prof. XXXXXXXXXXXXXXXXXXXX be asenior member of the IEEE.
REFERENCES
Reference #1 XXXXXXXXXXXXXXXReference #2 XXXXXXXXXXXXXXX

Reference Member # XXXXXXXXXX
Reference Member # XXXXXXXXXX