Address Line 2
Please provide a brief overview of your organization, including Mission statement, Continuing Education Student Body Size, Type of Business - Private, Proprietorship, or other- Business Highlights, Target Market, and whether you are Global, Domestic, or Both.
Please list all affiliates, subdivisions, and groups from your organization that will be participating in the program.
Which IEEE Field(s) of Interest does this course or program supplement or complement?
Please check all that apply:
Circuits & Systems
Geoscience & Remote Sensing
Instrumentation & Measurement
Power Engineering/ Power Electronics
Antennas & Propagation
Dielectrics & Electrical Insulation
Image & Signal Processing
Components, Packaging & Manufacturing Technology
Engineering in Medicine & Biology
Intelligent Transportation Systems
Microwave Theory & Techniques
Ultrasonics, Ferroelectrics & Frequency control
Nuclear & Plasma Sciences
Product Safety Engineering
Robotics & Automation
Social Implications of Technology
Lasers & Electro-Optics
Systems Man & Cybernetics
Other ( Please Specify Below)
Is your institution accredited by a professional credentialing organization.
If Yes, please specify accrediting body:
Do you currently have, or have you ever had, a relationship with IEEE?
If Yes, please describe:
What type of Courses or Programs do you offer?
Please provide a Web address with navigation instructions for locating the specific offerings you with to make available through IEEE: (Please provide multiple web addresses if needed)
How will these offerings be presented? (Check all that apply)
Traditional (in the classroom)
Are these offerings available in multiple languages?
Can students interact directly with the professor or presenter?
If so, please check all that apply:
Identify your primary competitors and describe how your offerings compare and contrast with theirs:
Are there supplemental materials (Books, papers, CDs, web sites, Etc.) for your offerings?
If yes, please check all that apply:
Please submit at least one instructor biography which best represents your course offerings.
Please submit at least one course discription which best represent your course offerings.
In one or two paragraphs, please describe the target audience for your organization's offers:
Describe how this offering benefits your intended audience:
Does this offering help professionals prepare to meet or maintain a certification or licensure?
Specify the type of credit (if any) earned upon completion of this offering:
Are you interested in any of the following? ( Please check all that apply)
Virtual Solutions (Virtual Event Sponsorship and Exhibition)
Let us know if you are interested in any additional opportunities not listed on this form:
Indicates Response Required