I would like to nominate the following individual for membership in Sigma Xi. I understand that the Committee on Qualifications and Membership will act as the seconder on my nomination.

I am not familiar with an active full or associate Sigma Xi member and would like the Committee on Qualifications and Membership to review my request for membership.

Nominee Profile:

Preferred Prefix (check one): Dr. Mr. Ms. Mrs.

First:

Middle:

Last:

Birth Date (mm/dd/yyyy):

Department/Building/Box:

Institution:

Street Address:

City: State:

Zip/Postal Code: Country:

Phone (include area code):

Fax (include area code):

E-Mail:

Employer Type (check one): academic; industrial; governmental;health care;manufacturing;research;other

Full Home Street Address (parent's address if student):

City State:

Zip/Postal Code: Country

Home Phone (include area code):

Cell Phone (include area code):

Which address should be used for Sigma Xi mailings? Business  Home

Is the Nominee a student? Yes  No

Ethnicity:
Sigma Xi is able to provide many student programs through generous donations from a variety of supporters. Often, these donations are based on Sigma Xi's ability to demonstrate that its programs serve a diverse audience. Your responses to demographic questions serve our diverse population.

  American Indian/Alaska Native Asian Black/African American Caucasian Hispanic Pacific IslanderMulti-Ethnic/Other

Your gender:   Female Male

Highest Degree (if a student, which degree is being sought)
PhD/DSc DDS/DMD DO DVM MD MA/MS BA/BS
Other:

Year Degree earned or expected:

Is the Nominee a post doc? Yes  No
If yes, dates of term. From:    To:

Major research field:
Agriculture/Soil Science/Natural Resources
Mathematics & Computer Sciences
Biological Sciences
Engineering Sciences
Health Sciences
Physical & Earth Sciences
Social Sciences
Other:

Nominee’s Education

Institution Name:

Degree earned: BA/BS MA/MS PhD/DSc MD DO DVM DDS/DMD

Year degree obtained:

Institution Name:

Degree earned: BA/BS MA/MS PhD/DSc MD DO DVM DDS/DMD

Year degree obtained:

Institution Name:

Degree earned: BA/BS MA/MS PhD/DSc MD DO DVM DDS/DMD

Year degree obtained:

Nominee’s Professional Career: List three most recent positions

Institution Name:

Position:

Starting Date:

Ending Date:

Institution Name:

Position:

Starting Date:

Ending Date:

Institution Name:

Position:

Starting Date:

Ending Date:

Chapter Affiliation

Would the nominee like to affiliate with a chapter, if elected?
No 
Yes, affiliate with Please Choose Abbott Laboratories Academy Of Natural Sciences Air Force Dayton Akron, University of Alabama, University of Alabama-Birmingham, University of Alabama in Huntsville, University of Alamo Alaska Chapter Albany Alberta, University Of Albion College Alcoa Alfred University Allegheny University Of Health Sciences Chapter American University American University Of Beirut Amherst College Andrews-Whirlpool Appalachian State University Argonne National Laboratory Arizona State University Arizona, University of Arkansas State University Arkansas-Fayetteville, University of Army Research Laboratory (ARL) Atlanta University Center Auburn University Australian Avalon B. P. America Ball State University Bangkok Thailand Barry University Baylor College Of Dentistry Baylor University Black Hills Regional Chapter Boeing North American Chapter Boise State University Boston University Bowling Green State University Bridgeport, University Of Brigham Young University British Columbia, University Of Brooklyn College Brown University Bryn Mawr College Bucknell University Butler-Indianapolis C. W. Post College Calgary, University of California Institute of Technology California Polytechnic State University California State Polytechnic University California State University-Bakersfield California State University-Chico California State University-Dominguez Hills California State University-Fresno California State University-Hayward California State University-Long Beach California State University-Northridge California State University-Sacramento California State University-San Bernardino California-Berkeley, University of California-Davis, University of California-Irvine, University Of California-Los Angeles, University of California-Merced, University of California-Riverside, University of California-Santa Barbara, University of California-Santa Cruz, University Of Calspan Corporation Carleton College Carnegie-Mellon University Carthage College Case Western Reserve University Catholic University of America Center For Naval Analyses Centers for Disease Control and Prevention Chapter Central Arkansas Chapter Central Florida, University Of Central Michigan University Central Missouri State University Central Oklahoma, University Of Central Savannah River Area Central Texas Research Society Charleston Charlotte Chapter Chesapeake Chicago Medical School Chicago, University of China Lake Cincinnati Federal Environmental Cincinnati, University of City College of the City University of New York Claremont Colleges Clarkson University Clear Lake Clemson University College of Mount Saint Vincent (Riverdale New York) Colorado School of Mines Colorado State University Colorado State University - Pueblo Colorado, University of Columbia University Chapter Columbia-Willamette Connecticut Health Center, University Of Connecticut, University of Cornell University Corning Incorporated Crompton Corporation D O E/N R C Dartmouth College David W. Taylor Dayton, University of Delaware, University of Delta Denison University Denver, University of Depauw-Wabash District Of Columbia Drexel University Dubuque Duke University DuPont Duquesne East Carolina University East Stroudsburg University Of Pennsylvania Eastern Illinois University Eastern Kentucky University Eastern Michigan University Eastern New Mexico University Eastern Oregon University Eastern Washington Univ-Spokane Eckerd College Emory University Emporia State University Fairfield University Fairleigh Dickinson University Findlay, The University of Florida A & M University Florida Atlantic University Florida Institute Of Technology Florida International University Florida State University Florida, University of Food and Drug Administration Ford Motor Company Fordham University Fort Hays Four Corners Franklin And Marshall College Frederick General Motors Research & Development Center Geneva George Mason University George Washington University Georgetown University Georgia Institute of Technology Georgia Southern University Georgia, University of Grand Valley State University Greater Des Moines Greater New Orleans Greenbrier Valley Greensboro Chapter Grove City College GTE Laboratories Guelph Gulf Coast Gustavus Adolphus College Hamilton College Hanscom Hartford Hartford, University Of Harvard Chapter Hawaii, University of Hawaii-Hilo, University Of Hollins University Holy Cross, College Of The Hope College Houston, University of Howard University Hughes Laboratories Humboldt State University Hungarian Chapter Hunter College Iberian Idaho State University Idaho, University of Illinois at Chicago, University of Illinois Institute of Technology Illinois State Univ/Illinios Wesleyan Univ Illinois, University of Indiana University Indiana University Medical Center Indiana University Of Pennsylvania Indiana University-Purdue University At Ft Wayne Iowa State University Iowa, University of Ithaca College Jacksonville John Deere Johns Hopkins University Johnson & Johnson Kalamazoo, Michigan Kansas City Kansas Medical Center, University of Kansas State University Kansas, University of Kennesaw State University Kent State University Kentucky, University of Kirksville Knox College Lafayette College Lake Forest College Lamar University Lawrence Livermore National Lab Lehigh University Lehman College Loma Linda University Longwood/Hampden Sydney Colleges Louisiana State University Chapter Louisiana Tech University Louisville Loyola Marymount University Loyola University Lynchburg M.W. Kellogg Magic Valley Maine, University of Manhattan College Manitoba Marquette University Marshall University Maryland, University of Massachusetts Institute of Technology Massachusetts, University of Massachusetts-Dartmouth, University Of Massachusetts-Lowell, University Of Mayo Foundation McDaniel College McGill-Montreal Mcmaster University Medical College of Ohio at Toledo Membership at Large Memphis, University Of Merrimack College Mesa State College Miami University-Ohio Miami, University of Michigan State University Michigan Technological University Michigan, University of Middle Tennessee State University Midland Minnesota at Duluth, University of Minnesota State University, Mankato Minnesota, University of Minot State University Mississippi Medical Center, University of Mississippi State University Mississippi, University of Missouri at Columbia, University of Missouri at St. Louis, University of Missouri University of Science and Technology Montana State University Montana Tech University Of Montana Montana, University of Montclair State University Monterrey, Institute Of Technology Mount Holyoke College Mount Sinai School Of Medicine Murray State University Muskingum College Nalco Chemical Natick National Institute of Standards and Technology Naval Air Warfare Center Training Systems Naval Postgraduate School Naval Research Laboratory-Edison Nebraska At Kearney, University Of Nebraska, University of Nevada, University of Nevada-Las Vegas, University Of New Hampshire, University of New Jersey Institute of Technology New Mexico Highlands University New Mexico Inst of Mining and Technology New Mexico State University New Mexico, University of New York University New York University College Of Dentistry New Zealand Chapter Newark Nordic North Carolina Central University North Carolina State University North Carolina-Asheville, University Of North Carolina-Chapel Hill, University Of North Carolina-Wilmington,University of North Dakota State University North Dakota, University of North Texas, University of Northeastern Oklahoma State University Northeastern University Northern Arizona Northern Colorado, University Of Northern Illinois University Northern Iowa, University of Northern Kentucky University Northern Michigan University Northern Westchester Northwest Indiana Northwestern Pennsylvania Northwestern State University Of Louisiana Northwestern University Notre Dame, University of Oak Ridge Oakland University Oberlin College Ohio Northern University Ohio State University Ohio University Ohio Wesleyan University Oklahoma Health Sci Center, University of Oklahoma State University Oklahoma, University of Olin Omaha Oneonta Orange County Oregon State University Oregon, University of Ottawa Pace University Panama City Pennsylvania State University Pennsylvania, University of Peoria Philadelphia College Of Osteopathic Medicine Picatinny Pikes Peak Pittsburgh, University Of Polytechnic Portland State University Prague Institute Of Advanced Studies Prairie View A & M University Princeton Providence College Puerto Rico At Mayaguez, University Of Puerto Rico At San Juan, University Of Purdue University Queens College Quinnipiac Ramapo College Of New Jersey Regis College Rensselaer Polytechnic Institute Research Triangle Park Chapter Rhode Island College Rhode Island, University of Rice University-Texas Medical Center Richmond, University Of Rider University Chapter Roanoke College Roche Research Rochester, University of Rockefeller University Rockford College Rollins College Rush University Rutgers, The State University Saint Bonaventure University Saint Cloud State University Saint Josephs University Saint Louis University Saint Mary's College of California Sam Houston State University San Diego San Francisco State University San Joaquin Valley San Jose State University Sangamon State University Santa Clara University Savannah Scranton, University Of Seton Hall University Shenandoah Valley Chapter Shreveport Slippery Rock University Smith College Sonoma State University South Alabama, University Of South Carolina, University of South Dakota State University South Dakota, University of South Florida Water Management District South Texas Chapter South, University Of The Southcentral Pennsylvania Southeast Missouri State University Southern Appalachian Southern California, University of Southern Illinois University-Carbondale Southern Illinois University-Edwardsville Southern Indiana Southern Maine Southern Methodist University Southern Mississippi, University of Southern Oregon Chapter Southern University Southwest Missouri State University Stanford University State University College At Brockport State University College At Buffalo State University College At Fredonia State University College At New Paltz State University College At Plattsburgh State University College At Oswego State University of West Georgia Stephen F. Austin State Univ Stevens Institute of Technology SUNY at Albany SUNY at Buffalo SUNY at Cortland SUNY at Purchase SUNY at Stony Brook SUNY Health Science Center at Brooklyn Swarthmore College Swiss Syracuse Chapter Tahoma Tampa Bay Tarleton State University Temple University Tennessee A & I Fisk-Meharry Tennessee At Chattanooga, University Of Tennessee At Martin, University Of Tennessee Memphis, University of Tennessee Technological University Tennessee, University of Texaco Research Center Texas A & M - Commerce Chapter Texas A & M University Texas at Arlington, University of Texas at Austin, University of Texas at Dallas, University of Texas at El Paso, University of Texas Christian University Texas Medical Branch, University of Texas Southwestern Medical Center, Univ Of Texas Tech University The University of Louisiana at Lafayette The University of Louisiana at Monroe Thomas Jefferson University Tidewater Virginia Tifton Toledo, University of Toronto, University of Towson Tri-Cities Washington Tri-State University Triple Cities New York Tufts University Tulsa Tuskegee University U.S. Naval Academy Union College Uniroyal Chemical University of the Sciences in Philadelphia Ursinus College Utah State University Utah, University of Vanderbilt University Vassar College Ventura County Vermont Chapter Villanova University Virginia Commonwealth University Virginia Polytechnic Institute and State Univ Virginia State University Virginia, University of Wabash Valley Wake Forest University Washington College Washington State University Washington University Washington, University of Waterways Experiment Station Wayne State University Weber State University Wellesley College Wesleyan University West Virginia University Westchester Western Carolina University Western Connecticut State University Western Illinois University Western Kentucky University Western Pennsylvania Western Washington University Whitman College-Walla Walla University Wichita State University Wilkes University William And Mary, College Of William Paterson University Williams College Wisconsin, University of Wisconsin-Eau Claire/Stout, University Of Wisconsin-Green Bay, University Of Wisconsin-La Crosse, University Of Wisconsin-Milwaukee, University Of Wisconsin-Oshkosh, University Of Wisconsin-Stevens Point, University Of Wittenberg University Woods Hole Wooster Ohio Worcester Polytechnic Institute Wright State University Wyoming, University of Yale University York College Of Cuny Youngstown State University

Type of Nomination
Membership in Sigma Xi is by nomination and is conferred in one of two ways. While paraphrased below, here is a link to the complete text of Article II, Section 3 of the Sigma Xi Constitution. Please indicate which type of membership this individual is seeking (select one):

Associate Membership is available to any individual who has, through initial research achievement in a field of pure or applied science, shown an aptitude for research, as evidenced by independent investigation ordinarily resulting in a written report. Associate membership is offered to encourage young investigators with promise to continue careers in research.

For Associate Membership, include a brief statement here regarding the nominee’s demonstrated research aptitude. Please limit your response in this space to 250 words. If you require additional space please e-mail a separate document to membership@sigmaxi.org.

Full Membership is conferred upon any individual who has shown noteworthy achievement as an original investigator in a field of pure or applied science. This noteworthy achievement must be evidenced by publication as the primary author (defined in the manner appropriate to the discipline) on at least two different articles published in a refereed journal, patents, or refereed monographs. Dissertations and theses alone are not considered sufficient for demonstration of this achievement and must be accompanied by at least two other publications. Please see the appropriate sections of the Constitution and Bylaws for additional information. Only Full Members are eligible to serve on Sigma Xi committees or take office on the Board of Directors.

Promotion to Full Membership is conferred upon any individual who, previously elected as an Associate Member, now satisfies the Full Membership qualifications. Promotion review will follow the same procedure as elections. Please see the Full Membership qualifications above. Only Full Members are eligible to serve on Sigma Xi committees or take office on the Board of Directors. Complete the information below. Please provide your member ID#:

For nomination or promotion to Membership, you MUST send a copy of your full Curriculum Vitae (CV) to membership@sigmaxi.org for review. If a CV is not e-mailed to membership@sigmaxi.org, your Membership application will be not be reviewed.

Nominator Information
The Committee on Qualifications and Membership will act as the seconder for all online nominations.
Note: If you are requesting the Committee on Qualifications and Membership to provide two nominators, you DO NOT need to fill out this section.

Name of Nominator:

First:

Middle:

Last:

Member ID # (if known):

Nominator’s E-Mail address:

Employer:

Position/Department:

Phone:

Member-Get-A-Member:
Recommended By:
Member ID# (if known):

Review Results
Allow up to 6 to 8 weeks for the Committee on Qualifications and Membership to review this nomination. Once the review is complete, you will be sent an e-mail from membership@sigmaxi.org with the results and further instructions. A dues payment is not required until after the review is completed and membership awarded.