EPS Student Chapter Activity Reports At the conclusion of an activity which have 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. For those activities where funds from EPS have been used, a scanned copy of a simple financial statement endorsed by the Student Chapter Advisor should also be inserted in a page of the report for that activity. Activities can 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.

EPS Student Chapter Activity Reports 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: Date(s): Description: (Please give details of activity below and the benefits of the activity. Please attach photographs of activities if available.) 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:   Funding: Was funding provided by EPS for this activity? If yes, please indicate how much and insert a scanned image of a simple financial statement endorsed by the Student Chapter Advisor on the next page.

REPORT ON ACTIVITY #2 Title: Category: Date(s): Description: (Please give details of activity below and the benefits of the activity. Please attach photographs of activities if available.) 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:   Funding: Was funding provided by EPS for this activity? If yes, please indicate how much and insert a scanned image of a simple financial statement endorsed by the Student Chapter Advisor on the next page.