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Sigma Xi Membership Nomination/Promotion Form

This form is only for submission of nominations to be reviewed by the Committee on Qualifications and Membership and SHOULD NOT be used for nominations to a particular chapter.

This form may be used to nominate an individual for membership or for promotion from associate to full membership. This form may also be used to request to be nominated for membership. After submitting this interactive form, a confirmation form will be generated. You should print the confirmation form and save it for your records.

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 a 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.

Your gender:

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

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.

Committee on Qualifications and Membership
Sigma Xi, The Scientific Research Society
3106 East NC Highway 54
P.O. Box 13975
Research Triangle Park, NC 27709
Telephone: 800-243-6534 or 919-549-4691
Fax: 919-549-0090
E-mail: membership@sigmaxi.org

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