North East Association for Institutional Research

Please indicate if you are applying for Emeritus Membership Status for yourself, or if you are nominating someone else for Emeritus Membership Status.

I am completing this form....
Choose 1

First Name of member for Emeritus Consideration (if this is a self-nomination, please indicate: Self) *

Last Name of Member for Emeritus consideration (if this is a self-nomination please indicate: Self) *

Email Address of Member for Emeritus consideration *

INSTITUTIONAL INFORMATION

What is the name of the Institution from which the potential Emeritus Member is retiring? *

Position (List the last position held before retiring) *

Effective Date of Retirement *

NEAIR MEMBERSHIP INFORMATION

Please email NEAIR at neair@neair.org for verification of membership years and involvement.

7 Year Criteria: Have you (f a self-nomination) or the member (if nominating another member) been a NEAIR member for 7 years - not necessarily consecutive *

Yes

No

Please select all the ways you/nominee have been involved in NEAIR *
Choose up to 13

Attended NEAIR Conference

Attended Workshop Session at Conference or Drive-In or Virtual Webinar

Received Grant Award

Presented Workshop Session (e.g., PDS, Pre-Conference, etc.)

Presented Session at the Annual Conference

Served as Mentor

Served as Officer (e.g., President, Secretary, Treasurer)

Served as Proposal Reviewer

Served on Steering Committee

Served on Standing Committee

Served on ad hoc Committee

Volunteered at Annual Conference

Other

If "Other", please specify

Please briefly summarize your NEAIR involvement and reason for seeking Emeritus Membership Status (fi a self-nomination) or your nominee's NEAIR involvement and why you are recommending Emeritus Membership Status.

THANK YOU!