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IEEE Conference Campaign Code Request

Conference Initiator Contact Info


Member Number*
Email *
Volunteer Position *
Name of Recipient (if different from above)
Phone Number *
State/Province *
Country *
Postal Code *
Campaign codes will be issued within 2 weeks from the date of submission

Conference Details


Conference Name *
Expected # of Attendees *
Planned Start Date *   .
Planned End Date *   .
Conference Location - State/Province *
Conference Location - Country *
IEEE Region (see map) *
For which Society would you like to offer free membership in this promotion? *
  Offer a free Society to higher grade members who join at this conference.
Attach PDF of campaign docs:
(i.e., application, marketing communication) *
Comments/Special Instructions