RAS-UAE Student Chapter Petition Application – The Robotics and Automation Society

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Proposed Chapter Information

Proposed Chapter Name *

Host Institution Name *

Host Institution Address *

Affiliated Department *

Faculty Advisor Information

First Name *

Last Name *

Title *

Department *

University *

Email Address *

Phone *

RAS-UAE Membership ID

Emirates ID *

Signed Faculty Advisor Endorsement Letter *

No file chosen

PDF format preferred

Founding Student Officers

Chair

First Name *

Last Name *

Student ID *

Program of Study *

Graduation Year *

Email Address *

Phone *

RAS-UAE Membership ID

Emirates ID *

Vice-Chair

First Name *

Last Name *

Student ID *

Program of Study *

Graduation Year *

Email Address *

Phone *

RAS-UAE Membership ID

Emirates ID *

Secretary

First Name *

Last Name *

Student ID *

Program of Study *

Graduation Year *

Email Address *

Phone *

RAS-UAE Membership ID

Emirates ID *

Treasurer

First Name *

Last Name *

Student ID *

Program of Study *

Graduation Year *

Email Address *

Phone *

RAS-UAE Membership ID

Emirates ID *

Founding Student Members

How many members do you have?Please tell us how many members you have.
Then, fill in the details for each member below and click the “Add member” button to add a new member.
You can add up to 10 members maximum.

Member 1

First Name

Last Name

Date Of Birth

Day

Month

Year

Emirates ID

Email Address

Phone

School or University

RAS-UAE Membership ID

Member 2

First Name

Last Name

Date Of Birth

Day

Month

Year

Emirates ID

Email Address

Phone

School or University

RAS-UAE Membership ID

Member 3

First Name

Last Name

Date Of Birth

Day

Month

Year

Emirates ID

Email Address

Phone

School or University

RAS-UAE Membership ID

Member 4

First Name

Last Name

Date Of Birth

Day

Month

Year

Emirates ID

Email Address

Phone

School or University

RAS-UAE Membership ID

Member 5

First Name

Last Name

Date Of Birth

Day

Month

Year

Emirates ID

Email Address

Phone

School or University

RAS-UAE Membership ID

Chapter Mission Statement & Goals *

Status of University Approval *

Evidence of University Recognition/Approval *

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Evidence of University Recognition/Approval (PDF, if "Approved")

Draft Chapter Constitution (PDF) *

No file chosen

Proposed Activities Plan for First Year *

No file chosen