IEEE Member Verification File Request Form：IEEE会员验证文件申请表

IEEE Member Verification File Request Form：IEEE会员验证文件申请 IEEE Member Verification File Request Form To: Submitter: IEEE Conference Operations Phone Phone: +1 855 340 4333 (Toll Free) Phone Email: +1 732 562 3878 Email: Date: Ieee-mce@ieee.org 1. Conference Name: 2. Conference Record #: 3. Select the month(s) you wish to receive the file: , Jan , Feb , Mar , Apr , May , Jun , Jul , Aug , Sep , Oct , Nov , Dec This file contains information in Microsoft Excel. Instructions for use will be within the file. The information is broken up in cells consisting of: ? IEEE Member Number ? Country of Origin ? First 5 characters of last name ? Society/Council Membership ? First character of first name ? Member grade 4. PERMISSION FOR USE of the IEEE Member Verification file: It is my understanding that the IEEE Member Verification file is a part of IEEE’s confidential and proprietary database. I agree to use this file only for checking to see if the registrants are IEEE members for the registrations of the conference specified above. Requestor’s Signature Date 5. Please email access to the the following email address: __________________________________________ Receiver’s Email Address 8/2008