Subir Chowdhury Medal of Quality Leadership

Nomination Form

* denotes required fields

Nominee
SAE Member Number (if applicable):
*Last Name:
*First Name:
Middle Name:
*Title/Position:
*Employer:
*Is the following mailing address: Home
Business
Department/Division:
Mail Stop:
*Street Address:
*City:
*State/Province:
*Zip+4/Postal Code:
*Country:
*Phone:
Fax:
*Email:
Undergraduate
Name of College or University:
Major:
Degree:
Graduation Date:

Graduate (if applicable)
Name of College or University:
Major:
Degree:
Graduation Date:

PhD (if applicable)
Name of College or University:
Major:
Degree:
Graduation Date:

*Basis for Nomination:
Below include a detailed discussion setting forth the basis for the nomination. Comments should specifically document the nominee's accomplishment(s) that impacted "quality" in mobility engineering, design and/or manufacture.
*Societal Impact:
Below include a description of the societal impact of the nominee's accomplishment.
*Professional Leadership:
Below describe the nominee's professional career in a leadership role focusing on quality in mobility engineering, including but not limited to, past work experience, society memberships, honors / awards, etc.
*SAE Contribution:
Below include a brief description of any contributions the nominee has made to SAE activities or programs.
Letters of Recommendation:
Provide at least two recommendation letters from individuals other than the nominator that support the nomination and briefly describe first-hand knowledge of the stated contribution. (Please include name, telephone number and email address, and forward to SAE Awards.)

Nominator
SAE Member Number (if applicable):
*Last Name:
*First Name:
Middle Name:
*Title/Position:
*Employer:
*Is the following mailing address: Home
Business
Department/Division:
Mail Stop:
*Street Address:
*City:
*State/Province:
*Zip+4/Postal Code:
*Country:
*Phone:
Fax:
*Email:
*Date of Nomination:

Submit
Nomination Deadline: June 15

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