Society for Experimental Mechanics (SEM)

SEM Award Nomination Form

This form will provide the only information used in the final balloting for a Society for Experimental Mechanics award.

This form MUST be filled completely.
Nominations for the Tatnall Award for service to SEM need only complete 1, 2, 3, 9, 13, 14 and 15.

1. Candidate Name

First Name
Middle Initial
Last Name

2. Name of Award

3. Nominee's primary employment position and Institution

Title

Institution

Address

Phone

Email

4. Education
List all degrees earned, dates, major fields and institutions:

5. Technical Area

6. Accomplishments
Specific outstanding technical and professional engineering accomplishments and contributions meriting the Award:

7. Impact of Work
Impact of work (technical, commercial, national, etc.) cited in item 6:

8. Professional Work Experience
Record of professional work experience (list principal positions and describe primary responsibilities for each; include dates):

9. Memberships
Principal technical society memberships (including grades) and activities; important offices held and contributions to the Society for Experimental Mechanics; noteworthy pertinent accomplishments in engineering. Nominations for the Tatnall award for service to SEM should state all accomplishments here.

10. Recognition
Professional recognition (honors, awards, prizes, honorary degrees, etc.; give name of award and date):

11. Contributions
Contributions of record related to the criteria for the Award (list complete citations, including all authors for five publications with the most significant impact.)

a

b

c

d

e

12. Summary

Refereed journal articles
Patents
Books
Book chapters
Conf. proceedings
Other publications
Other contributions of record (explain).

13. Proposed citation

(Not more than 20 carefully edited words that reflect specific documented contributions):

14. References

I have obtained personally from each individual listed as a reference an indication of willingness to serve in that capacity. (Note: References may be active or retired SEM members.)

	Name	Affiliation
1
2
3

15. Nominator:

(Note: Nominator must be an active SEM member.)

Name
Affiliation
Phone
Email (required)
Please copy the number 281119 into the box to the right.

Please arrange for all references to send a letter of recommendation (maximum of two pages) directly to:

Email (Preferred): director@sem1.com

Mail:
Thomas Proulx
Society for Experimental Mechanics, Inc.
7 School Street
Bethel, CT 06801 USA