EPS Student Chapter Report on EPS-Subsidised Activity At the conclusion of an activity which has been subsidized by EPS, the Student Chapter must submit a follow-up report to the EPS Director of Student Programs briefly describing the activity, the attendance and the benefits. For this purpose, please complete the forms in the next few pages and add more page as necessary. Where possible, captioned photographs should be included in your report. Activities should be categorized as technical (seminars, workshops, etc), administrative (committee meetings, AGM, etc), social and others. If more than one activity is to be reported please add as many template pages as required. Financial Report: 1. A financial statement should be submitted as soon as possible after the event for which financial subsidy from EPS has been provided. 2. Any excess of budget over actual expenditure should be maintained in the chapter's bank account for future use for official chapter activities. It will be taken into account in future applications for EPS subsidies. 3. This statement should be included in the Activity Report and forwarded by the Submitter to the Student Chapter Advisor who should check and approve the statement via email. 4. Thereafter this Activity Report should be submitted to the EPS Director of Student Programs. 5. By submitting this report, the Submitter certifies that the financial statement has been checked and approved by his Student Chapter Advisor.

EPS Student Chapter Subsidised Activity Report Student Chapter Name: Student Chapter Code: Submitter’s Name: Submitter’s Email: Chapter Faculty Advisor: Chapter Faculty Advisor Email: IEEE Section: IEEE Region Number: Date submitted:

REPORT ON ACTIVITY #1 Title: Category: (Technical, Administrative, Social) Date(s): Description: (Please give brief details of activity below and the benefits of the activity) Attendance: Number of IEEE/EPS member attendees: Number of Non-IEEE Member attendees: Number of EPS Student Member attendees: Number of Non-EPS Students: Total:

Financial Statement on EPS-Subsidized Acitvity (US$) DATE: ___________ TITLE OF ACTIVITY:________________________________________________________________________________________________ SUBSIDY FROM EPS OR BALANCE THEREOF $ -   DESCRIPTION OF EXPENSES CHARGED TO EPS SUBSIDY 1 $ - 2 3 4 5 6 7 TOTAL EXPENSES BALANCE

Please attach photographs of activities below if available (add more pages if necessary):

REPORT ON ACTIVITY #2 Title: Category: (Technical, Administrative, Social) Date(s): Description: (Please give brief details of activity below and the benefits of the activity) Attendance: Number of IEEE/EPS member attendees: Number of Non-IEEE Member attendees: Number of EPS Student Member attendees: Number of Non-EPS Students: Total:

Financial Statement on EPS-Subsidized Acitvity (US$) DATE: ___________ TITLE OF ACTIVITY:________________________________________________________________________________________________ SUBSIDY FROM EPS OR BALANCE THEREOF $ -   DESCRIPTION OF EXPENSES CHARGED TO EPS SUBSIDY 1 $ - 2 3 4 5 6 7 TOTAL EXPENSES BALANCE

Please attach photographs of activities below if available (add more pages if necessary):