IEEE Sensors Council Request for DL Funding

CHAPTER INFORMATION (OR INVITING ORGANIZATION INFORMATION)

Name of Chapter or Organization*

Chapter chair (or Responsible Person)*

Chapter (or Organization) address*

Expected attendance*

Chapter officer (or Organization representative) filing request*

Phone*

Email*

DISTINGUISHED LECTURER INFORMATION

Name

First Last

Proposed date of lecture

IMPORTANT: All lecture visits must be approved in advance by the DLP chair. The DLP reimburses only approved visits. Local expenses are paid by the inviting organization and/or the lecturer. Please make requests at least six weeks before the proposed presentation.

Proposed topic*

Mode of travel and estimated travel cost (total) (attach a detailed daily breakdown of the costs to this form)

Breakdown of daily travel cost*

Max. file size: 50 MB.

Name of Chapter Officer or the DL submitting this request

First Last