Application for Best Woman Professional Award 2025 Please enable JavaScript in your browser to complete this form.1. IEEE Membership DetailsIEEE Membership Number *Current IEEE Member or should have been an IEEE Member for a duration of 1 year at least within the previous 3 years (before the month and year of commencement of application).Attach Membership Card * Click or drag a file to this area to upload. .jpeg or jpg files only, less than 1mb.Member since - Month *JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberMonthMember since - Year *Year2. Personal DetailsName of Nominee *Email *EmailConfirm EmailPhone number *Address for correspondenceAddress Line 1 *Address Line 1Address Line 2 *Address Line 2City *CityState *Andhra PradeshArunachal PradeshAssamBiharChhattisgarhGoaGujaratHaryanaHimachal PradeshJharkhandKarnatakaKeralaMadhya PradeshMaharashtraManipurMeghalayaMizoramNagalandOdishaPunjabRajasthanSikkimTamil NaduTelanganaTripuraUttar PradeshUttarakhandWest BengalPostal code *Postal codeCountry *Country3. NationalityCountry *IndiaDocument *PassportVoter's IdPANOtherOther DocumentName of the document other than those listed above.Attach Here * Click or drag a file to this area to upload. .jpeg or jpg files only, less than 1mb.4. Educationa. Undergraduate DegreeName of Degree *B.EB.TechB.ScBCSBCAOthersName of Other Degree *Name of the Degree other than those listed above.Specialization *Computer EngineeringInformation TechnologyElectronicsElectricalECEE&TCEEEMechanicalChemicalCivilProductionMathematicsOthersSpecify the Specialization *Name of the Specialization other than those listed above.Name of the University *Passing Year *20202019201820172016201520142013201220112010200920082007200620052004200320022001Marks (Consolidated GPA / Percentage) *b. Post Graduate Degree (if applicable)Name of DegreeM.EM.TechM.SM.ScMCSMCAOthersOther DegreeName of Degree other than those listed aboveMarks of First Year (Consolidated GPA / Percentage)Name of the UniversityPassing Year20202019201820172016201520142013201220112010200920082007200620052004200320022001Marks of Second Year (Consolidated GPA / Percentage)c. PhD Studies (if applicable)PhD DomainScienceEngineeringTechnologyUniversity / InstitutePh.D. research started MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberMonthYear2019201820172016201520142013201220112010200920082007200620052004200320022001YearTopic of ResearchPh.D. degree awarded / Defence Completed MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecemberMonthYear20242023202220212020201920182017201620152014201320122011201020092008200720062005Yeard. Post-Doctoral Research (if applicable)Duration FromTo Certificate 11. Institute/ OrganisationInstitute/Organisation where Post Doctoral Research was pursued.Funding AgencyDomain5. Co-curricular/Extra-Curricular AchievementsCo-curricular Achievements – Please list down your top achievements (maximum 5) *Extra - curricular Achievements – Please list down your top achievements (maximum 5) *6. Work Experience (Including research)Total Work Experience (Years)Years2.533.544.555.566.57Current Position / Designation held *Name of the Institute / Organization *Current Position / Designation held sinceMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Current Job Profile (in brief) *Work Experience Certificate (current position) * Click or drag a file to this area to upload. Attach bonafide letter from institute/organisation mentioning duration of employment and designationSame as previousSelect if previous position/ designation is same as current position Previous Position Previous Position / Designation heldName of the Institute / OrganizationDate of joiningDate of leaving Add Position Remove Position Relieving Letters Click or drag files to this area to upload. You can upload up to 10 files. Attach relieving letters/experience certificates for previous positions/designations held (jpg, png, or pdf format)7. Professional Achievements in the last 3-5 years (including entrepreneurial / leadership / organizational achievements)a. Please list down your top Professional achievements (maximum 5) *Achievement 1:8. ResearchTotal no. of Research Papers Published Reseach Published in Journal TitleAuthorsNames of Authors separated by commaName of the JournalPublisherYearVolumeIssuePageTypeScopusInternationalNationalUGCWeb Link (URL)SCI/ESCIApplicable for Scopus Add Journal Entry Remove Journal Entry Research Published in Conference TitleAuthorsNames of Authors separated by commaConference TitlePublication NameYearVolumeIssuePageTypeScopusInternationalNationalUGCWeb Link (URL) Add Conference Entry Remove Conference Entry Research Published in Book TitleAuthorsNames of Authors separated by commaArticle TitleArticle AuthorBook TitleBook AuthorPublilsherYearVolumePageWeb Link (URL) Add Book Entry Remove Book Entry Total no. of Patents GrantedPlease include only those patents that have been granted or published (do not mention patents that have been applied). Patent Details Application NumberTitleApplication DateField of InventionInventor Names(follow same sequence as in patent application)Date of Examination (FER)Individual Contribution for Invention Add Patent Remove Patent Total Number of Sponsored Research/ Projects Research/Project Details Multiple ChoiceResearchProjectFromToTitleName of PIInstitute/OrganisationInstitute/organisation where research/project is being conductedFunding AgencyDomain Add Research/Project Entry Remove Research/Project Entry 9. Contributions towards organization / community / society / nation List Your Contribution Towards Technical Development (in about 150 words) *List Your Contribution Towards Social / Economic Development (in about 150 words) *10. Recommendation 1Name of person recommending *His / Her Designation *Organization where he / she works *His / her contact number His / her email id *Recommendation Letter (Scanned Copy) Click or drag a file to this area to upload. Max File Size : 200 KBRecommendation letters can also be mailed directly by the Referee to info@hfrc-ieee.orgTick box to state that we can contact the person for verificationI agree11. Recommendation 2Name of person recommending *His / Her Designation *Organization where he / she works *His / her contact numberHis / her email id *Recommendation Letter (Scanned Copy) Click or drag a file to this area to upload. Max File Size : 200 KBRecommendation letters can also be mailed directly by the Referee to info@hfrc-ieee.orgTick box to state that we can contact the person for verification I agreeStatement of Worthiness & include how the prize money would be used (200 words) *Please upload certificates/credentials that validate your academic, co-curricular, and extracurricular achievements. The files can be in jpg/pdf format only. Recommendation letters/experience certificates or other content in MS Word files may be scanned and converted to jpg/pdf and then uploaded. Each file being attached should not be more than 200 KB. Consolidated Degree Marksheet * Click or drag a file to this area to upload. Degree Certificate * Click or drag a file to this area to upload. Consolidated Masters Degree Marksheet * Click or drag a file to this area to upload. Masters Degree Certificate * Click or drag a file to this area to upload. Ph.D Certificate Click or drag a file to this area to upload. Post Doctoral Certificate Click or drag a file to this area to upload. Any Additional Certificates Click or drag files to this area to upload. You can upload up to 10 files. If any additional file / credential needs to be shared with the Award committee, please mail it to info@hfrc-ieeeawards.org Declaration: I hereby declare that the particulars furnished by me in this nomination / application form are true and correct to the best of my knowledge and belief. In case any information is found to be incorrect / false, my candidature shall be liable to be rejected. *I AgreeSubmit
