AMERICAN AUTOMATIC CONTROL COUNCIL

AWARD NOMINATION FORM FOR

Richard E. Bellman Award

Donald P. Eckman Award

John R. Ragazzini Award

Control Engineering Practice Award

A. BACKGROUND DATA

1.  Name of Award______________________________________________
            Today's Date___________________________

2.  Name of Nominee___________________________________________ 
             Date of Birth___________________________

3.  Present Position (exact title)_____________________________________      Telephone (____)_______________________

    
Address____________________________________________________      __________________________________________

        Institution or Company                               City and State   --     Zip

4. University Education:

    Institution                                            Degree           Year             Major    

    _____________________________________________          ________         ______   _____________________

    _____________________________________________          ________         ______   _____________________

    _____________________________________________          ________         ______   _____________________

    _____________________________________________          ________         ______   _____________________

    _____________________________________________          ________         ______   _____________________

5. Positions Held:

    Company or Institution                                          Position or Title                 Dates

    ___________________________________________________             _________________________         _______________

    ___________________________________________________             _________________________         _______________  

    ___________________________________________________             _________________________         _______________  

    ___________________________________________________             _________________________         _______________  

    ___________________________________________________             _________________________         _______________  

Sponsor's Name and Address____________________________________________________________________________

____________________________________________________________________________________________________

Sponsor's Signature____________________________________________________________________________________

7. Academic and Professional Honors (include awards and prizes, membership in honorary societies and date the honor was received.)

B. CITATION

Proposed citation (not more than 30 carefully edited words that reflect specific accomplishments).

_________________________________________________________________________________________________

_________________________________________________________________________________________________

C. QUALIFICATIONS

1. Identification and evaluation of the accomplishments on which the nomination is based (maximum of two double-spaced pages).

2. Selected bibliography (including books, patents and major papers published).

D. SUPPORTING LETTERS

Letters from at least three (3) but not more than five (5) individuals whose names are listed below. Awards

Committee members and Subcommittee members for the award may not write supporting letters.

                       Name                     Affiliation

1.  ____________________________________  _________________________________________________

2.  ____________________________________ _________________________________________________

3.  ___________________________________ _________________________________________________

4.  ____________________________________ _________________________________________________

5.  ____________________________________ _________________________________________________

SEND SEVEN COPIES OF THE COMPLETE NOMINATION PACKAGE TO THE AACC SECRETARY, BY DECEMBER 1.