SPAx Event Reporting

Thank you for reporting your SPAx Event! We hope the event went well and look forward to telling your story.

Name(Required)

First Last

Email(Required)

Student Branch Officer Position(Required)

School Name(Required)

Student Branch Number(Required)

Country(Required)

IEEE Section(Required)

IEEE Region(Required)

Event Name(Required)

Event Date(s) (Day Month Year)(Required)

Number of IEEE Attendees(Required)

Total number of IEEE members who attended the event. Do not include non-IEEE members in this number.

Number of non-IEEE Attendees(Required)

Total number of non-IEEE members who attended the event. Do not include IEEE members in this number.

Number of IEEE Volunteers(Required)

Total IEEE members who volunteered for this event (not including speakers)

Objectives and Motivation of the Event(Required)

0 of 500 max characters

Event Description(Required)

0 of 500 max characters

Speaker Name(s), topic(s), and brief speaker biography(ies)(Required)

Speaker biographies should be no more than 1-2 sentences

Student Branch Social Media Handle(s)

Optional if you would like your Student Branch to be tagged in social media posts related to this event

Upload photos here(Required)

Drop files here or

Accepted file types: jpg, jpeg, png, pneg, Max. file size: 200 MB, Max. files: 10.

Please upload files of these formats (.jpg, .jpeg, .png, .pneg)

Consent(Required)

I agree to the submission policy

1. CONSENT AND RELEASE: By agreeing to the submission policy, I hereby grant IEEE, its representatives, and assigns the
right to use, reproduce, edit, publish, and distribute any and all photographs, audio/voice recordings, video recordings,
written materials, use of name, and other content taken of me (or my minor child, if applicable) or provided by me (or my
minor child, if applicable) (collectively, “Materials”), anywhere in the world for any lawful business purpose as of the date
this release is signed. This includes, but is not limited to, a right to use the Materials for any IEEE websites, social media
platforms, media, promotional materials, publications, advertisements, broadcasts, employee communications, conferences,
educational resources. I represent that I am able to participate in the Opportunity and that, to the extent it is required, I have
obtained the permission of my employer, institution, etc. prior to my participation.
2. SCOPE OF USE: I understand and agree that the Materials may be used in various media formats including, but not
limited to, print, digital, and electronic media, and may be displayed publicly or privately. IEEE may use the Materials, in
whole or in part, with or without my name (or my minor child’s name) and may alter the Materials without further inspection
or approval by me. All uses described herein using Materials shall be referred to as IEEE Content.
3. NO COMPENSATION: I understand that I (or my minor child) will not receive any compensation, payment, royalty, or
any other remuneration, now or in the future, for the use of the Materials by IEEE.
4. RIGHTS; WAIVER OF INSPECTION: I hereby waive any right to inspect or approve the finished product or any
derivative works that may be created from the Materials or any IEEE Content. I understand that all rights to the IEEE
Content, including copyrights, are retained by IEEE and that I shall have no ownership in any of the IEEE Content .
5. DURATION OF USE: This authorization is effective indefinitely and extends to the use of the Materials in any and all
future IEEE reprints, reproductions, or derivative works. You have the right to withdraw your consent. If consent is later
revoked via writing, IEEE shall cease use of the Materials beginning on the date the revocation is received but shall have no
obligation to retract, remove, destroy or cease using any previously printed or published IEEE Content that incorporates the
Materials.
6. RELEASE OF LIABILITY: I hereby release and hold harmless IEEE, its representatives, and assigns from any and all
claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons
acting on my behalf or on behalf of my estate may have by reason of this authorization including, but not limited to, any
claims for defamation, invasion of privacy, or infringement of moral rights or rights of publicity arising from the use of the
Materials.
7. CONSENT FOR MINORS (If Applicable): If the participant is a minor, I, as the parent or legal guardian, have read and
understand the terms of this release and consent to the use of such Materials involving my minor child under the terms set
forth herein.
ACKNOWLEDGMENT AND AGREEMENT: By agreeing to the submission policy, I acknowledge that I have read and understood this
Release Form and agree to its terms. I certify that I am of legal age (if signing for myself) or the parent/legal guardian of the
minor participant and that I have full authority to grant the rights and permissions herein described.

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