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<option value="17">The Bahamas</option> <option value="18">Bahrain</option> <option value="19">Baker Island</option> <option value="20">Bangladesh</option> <option value="21">Barbados</option> <option value="22">Bassas da India</option> <option value="23">Belarus</option> <option value="24">Belgium</option> <option value="25">Belize</option> <option value="26">Benin</option> <option value="27">Bermuda</option> <option value="28">Bhutan</option> <option value="29">Bolivia</option> <option value="30">Bosnia and Herzegovina</option> <option value="31">Botswana</option> <option value="32">Bouvet Island</option> <option value="33">Brazil</option> <option value="34">British Indian Ocean Territory</option> <option value="35">British Virgin Islands</option> <option value="36">Brunei Darussalam</option> <option value="37">Bulgaria</option> <option value="38">Burkina Faso</option> <option value="39">Burma</option> <option value="40">Burundi</option> <option value="41">Cambodia</option> <option value="42">Cameroon</option> <option value="43">Canada</option> <option value="44">Cape Verde</option> <option value="45">Cayman Islands</option> <option value="46">Central African Republic</option> <option value="47">Chad</option> <option value="48">Chile</option> <option value="49">China</option> <option value="50">Christmas Island</option> <option value="51">Clipperton Island</option> <option value="52">Cocos (Keeling) Islands</option> <option value="53">Colombia</option> <option value="54">Comoros</option> <option value="55">Congo, Democratic Republic of the</option> <option value="56">Congo, Republic of the</option> <option value="57">Cook Islands</option> <option value="58">Coral Sea Islands</option> <option value="59">Costa Rica</option> <option value="60">Cote d'Ivoire</option> <option value="61">Croatia</option> <option value="62">Cuba</option> <option value="63">Cyprus</option> <option value="64">Czech Republic</option> <option value="65">Denmark</option> <option value="66">Djibouti</option> <option value="67">Dominica</option> <option value="68">Dominican Republic</option> <option value="69">East Timor</option> <option value="70">Ecuador</option> <option value="71">Egypt</option> <option value="72">El Salvador</option> <option value="73">Equatorial Guinea</option> <option value="74">Eritrea</option> <option value="75">Estonia</option> <option value="76">Ethiopia</option> <option value="77">Europa Island</option> <option value="78">Falkland Islands (Islas Malvinas)</option> <option value="79">Faroe Islands</option> <option value="80">Fiji</option> <option value="81">Finland</option> <option value="82">France</option> <option value="83">France, Metropolitan</option> <option value="84">French Guiana</option> <option value="85">French Polynesia</option> <option value="86">French Southern and Antarctic Lands</option> <option value="87">Gabon</option> <option value="88">The Gambia</option> <option value="89">Gaza Strip</option> <option value="90">Georgia</option> <option value="91">Germany</option> <option value="92">Ghana</option> <option value="93">Gibraltar</option> <option value="94">Glorioso Islands</option> <option value="95">Greece</option> <option value="96">Greenland</option> <option value="97">Grenada</option> <option value="98">Guadeloupe</option> <option value="99">Guam</option> <option value="100">Guatemala</option> <option value="101">Guernsey</option> <option value="102">Guinea</option> <option value="103">Guinea-Bissau</option> <option value="104">Guyana</option> <option value="105">Haiti</option> <option value="106">Heard Island and McDonald Islands</option> <option value="107">Holy See (Vatican City)</option> <option value="108">Honduras</option> <option value="109">Hong Kong (SAR)</option> <option value="110">Howland Island</option> <option value="111">Hungary</option> <option value="112">Iceland</option> <option value="113">India</option> <option value="114">Indonesia</option> <option value="115">Iran</option> <option value="116">Iraq</option> <option value="117">Ireland</option> <option value="118">Israel</option> <option value="119">Italy</option> <option value="120">Jamaica</option> <option value="121">Jan Mayen</option> <option value="122">Japan</option> <option value="123">Jarvis Island</option> <option value="124">Jersey</option> <option value="125">Johnston Atoll</option> <option value="126">Jordan</option> <option value="127">Juan de Nova Island</option> <option value="128">Kazakhstan</option> <option value="129">Kenya</option> <option value="130">Kingman Reef</option> <option value="131">Kiribati</option> <option value="132">Korea, North</option> <option value="133">Korea, South</option> <option value="276">Kosovo</option> <option value="134">Kuwait</option> <option value="135">Kyrgyzstan</option> <option value="136">Laos</option> <option value="137">Latvia</option> <option value="138">Lebanon</option> <option value="139">Lesotho</option> <option value="140">Liberia</option> <option value="141">Libya</option> <option value="142">Liechtenstein</option> <option value="143">Lithuania</option> <option value="144">Luxembourg</option> <option value="145">Macao</option> <option value="146">Macedonia, The Former Yugoslav Republic of</option> <option value="147">Madagascar</option> <option value="148">Malawi</option> <option value="149">Malaysia</option> <option value="150">Maldives</option> <option value="151">Mali</option> <option value="152">Malta</option> <option value="153">Man, Isle of</option> <option value="154">Marshall Islands</option> <option value="155">Martinique</option> <option value="156">Mauritania</option> <option value="157">Mauritius</option> <option value="158">Mayotte</option> <option value="159">Mexico</option> <option value="160">Micronesia, Federated States of</option> <option value="161">Midway Islands</option> <option value="162">Miscellaneous (French)</option> <option value="163">Moldova</option> <option value="164">Monaco</option> <option value="165">Mongolia</option> <option value="166">Montenegro</option> <option value="167">Montserrat</option> <option value="168">Morocco</option> <option value="169">Mozambique</option> <option value="170">Myanmar</option> <option value="171">Namibia</option> <option value="172">Nauru</option> <option value="173">Navassa Island</option> <option value="174">Nepal</option> <option value="175">Netherlands</option> <option value="176">Netherlands Antilles</option> <option value="177">New Caledonia</option> <option value="178">New Zealand</option> <option value="179">Nicaragua</option> <option value="180">Niger</option> <option value="181">Nigeria</option> <option value="182">Niue</option> <option value="183">Norfolk Island</option> <option value="184">Northern Mariana Islands</option> <option value="185">Norway</option> <option value="186">Oman</option> <option value="187">Pakistan</option> <option value="188">Palau</option> <option value="189">Palmyra Atoll</option> <option value="190">Panama</option> <option value="191">Papua New Guinea</option> <option value="192">Paracel Islands</option> <option value="193">Paraguay</option> <option value="194">Peru</option> <option value="195">Philippines</option> <option value="196">Pitcairn Islands</option> <option value="197">Poland</option> <option value="198">Portugal</option> <option value="199">Puerto Rico</option> <option value="200">Qatar</option> <option value="201">R螛union</option> <option value="202">Romania</option> <option value="203">Russia</option> <option value="204">Rwanda</option> <option value="205">Saint Helena</option> <option value="206">Saint Kitts and Nevis</option> <option value="207">Saint Lucia</option> <option value="208">Saint Pierre and Miquelon</option> <option value="209">Saint Vincent and the Grenadines</option> <option value="210">Samoa</option> <option value="211">San Marino</option> <option value="212">S蟺o Tom螛 and Pr蠁ncipe</option> <option value="213">Saudi Arabia</option> <option value="214">Senegal</option> <option value="215">Serbia</option> <option value="216">Serbia and Montenegro</option> <option value="217">Seychelles</option> <option value="218">Sierra Leone</option> <option value="219">Singapore</option> <option value="220">Slovakia</option> <option value="221">Slovenia</option> <option value="222">Solomon Islands</option> <option value="223">Somalia</option> <option value="224">South Africa</option> <option value="225">South Georgia and the South Sandwich Islands</option> <option value="226">Spain</option> <option value="227">Spratly Islands</option> <option value="228">Sri Lanka</option> <option value="229">Sudan</option> <option value="230">Suriname</option> <option value="231">Svalbard</option> <option value="232">Swaziland</option> <option value="233">Sweden</option> <option value="234">Switzerland</option> <option value="235">Syria</option> <option value="236">Taiwan</option> <option value="237">Tajikistan</option> <option value="238">Tanzania</option> <option value="239">Thailand</option> <option value="240">Togo</option> <option value="241">Tokelau</option> <option value="242">Tonga</option> <option value="243">Trinidad and Tobago</option> <option value="244">Tromelin Island</option> <option value="245">Tunisia</option> <option value="246">Turkey</option> <option value="247">Turkmenistan</option> <option value="248">Turks and Caicos Islands</option> <option value="249">Tuvalu</option> <option value="250">Uganda</option> <option value="251">Ukraine</option> <option value="252">United Arab Emirates</option> <option value="253">United Kingdom</option> <option value="254">United States</option> <option value="255">United States Minor Outlying Islands</option> <option value="256">Uruguay</option> <option value="257">Uzbekistan</option> <option value="258">Vanuatu</option> <option value="259">Venezuela</option> <option value="260">Vietnam</option> <option value="261">Virgin Islands</option> <option value="262">Virgin Islands (UK)</option> <option value="263">Virgin Islands (US)</option> <option value="264">Wake Island</option> <option value="265">Wallis and Futuna</option> <option value="266">West Bank</option> <option value="267">Western Sahara</option> <option value="268">Western Samoa</option> <option value="269">World</option> <option value="270">Yemen</option> <option value="271">Yugoslavia</option> <option value="272">Zaire</option> <option value="273">Zambia</option> <option value="274">Zimbabwe</option> <option value="275">Palestinian Territory, Occupied</option> </select> </div> <div class="row-fluid"> <label>Affiliation</label> <div class="alert form-alert" id="form-alert-affiliation">Please enter Affiliation</div> <input class="span4" id="affiliation" name="affiliation" type="text" placeholder="Your Affiliation" /> </div> <div class="row-fluid"> <label for="domainselect">Research Domains <small></small></label> <input class="span4" id="domainselect" name="domainselect" type="text" placeholder="Your Domain of Research" /> </div> <div class="row-fluid"> <label>Upload CV (file size < 1 MB)</label> <div class="alert form-alert" id="form-alert-resume">Please upload your Resume </div> <input class="span4" id="resume" name="resume" type="file" placeholder="Upload Resume" /> </div> <div class="row-fluid"> <label>Upload Profile Picture (file size < 500 KB)</label> <div class="alert form-alert" id="form-alert-picture">Please upload your profile picture</div> <input class="span4" id="picture" name="picture" type="file" placeholder="Upload Profile Picture" /> </div> <div class="row-fluid"> <label>Short Bio</label> <div class="alert form-alert" id="form-alert-bio">Please enter your Biography</div> <textarea class="span4 long" id="bio" name="bio" placeholder="Your Biography"></textarea> </div> <div class="row-fluid"> <label>Select IEEE/ACM Membership Level</label> <select class="span4" name="MembershipLevel"> <option value="-1">Select</option> <option value="No">I am not an IEEE/ACM member</option> <option value="Member">Member</option> <option value="Associate Member">Associate Member</option> <option value="Senior Member">Senior Member</option> <option value="Fellow Member">Fellow Member</option> <option value="Chair">Chair</option> <option value="Vice Chair">Vice Chair</option> <option value="Chapter Chair">Chapter Chair</option> </select> </div> <div class="row-fluid"> <label>Select IEEE/ACM Society/Group (Hold down the Ctrl (windows) / Command (Mac) button to select multiple options.)</label> <select class="span4" name="MembershipSociety" multiple> <option value="No">I am not an IEEE/ACM member</option> <option value="IEEE">IEEE</option> <option value="ACM">ACM</option> <option value="IEEE Aerospace and Electronic Systems Society">IEEE Aerospace and Electronic Systems Society</option> <option value="IEEE Antennas and Propagation Society">IEEE Antennas and Propagation Society</option> <option value="IEEE Broadcast Technology Society">IEEE Broadcast Technology Society</option> <option value="IEEE Circuits and Systems Society">IEEE Circuits and Systems Society</option> <option value="IEEE Communications Society">IEEE Communications Society</option> <option value="IEEE Components, Packaging, and Manufacturing Technology Society">IEEE Components, Packaging, and Manufacturing Technology Society</option> <option value="IEEE Computational Intelligence Society">IEEE Computational Intelligence Society</option> <option value="IEEE Computer Society">IEEE Computer Society</option> <option value="IEEE Consumer Electronics Society">IEEE Consumer Electronics Society</option> <option value="IEEE Control Systems Society">IEEE Control Systems Society</option> <option value="IEEE Dielectrics and Electrical Insulation Society">IEEE Dielectrics and Electrical Insulation Society</option> <option value="IEEE Education Society">IEEE Education Society</option> <option value="IEEE Electron Devices Society">IEEE Electron Devices Society</option> <option value="IEEE Electromagnetic Compatibility Society">IEEE Electromagnetic Compatibility Society</option> <option value="IEEE Engineering in Medicine and Biology Society">IEEE Engineering in Medicine and Biology Society</option> <option value="IEEE Geoscience and Remote Sensing Society">IEEE Geoscience and Remote Sensing Society</option> <option value="IEEE Industrial Electronics Society">IEEE Industrial Electronics Society</option> <option value="IEEE Industry Applications Society">IEEE Industry Applications Society</option> <option value="IEEE Information Theory Society">IEEE Information Theory Society</option> <option value="IEEE Instrumentation and Measurement Society">IEEE Instrumentation and Measurement Society</option> <option value="IEEE Intelligent Transportation Systems Society">IEEE Intelligent Transportation Systems Society</option> <option value="IEEE Magnetics Society">IEEE Magnetics Society</option> <option value="IEEE Microwave Theory and Techniques Society">IEEE Microwave Theory and Techniques Society</option> <option value="IEEE Nuclear and Plasma Sciences Society">IEEE Nuclear and Plasma Sciences Society</option> <option value="IEEE Oceanic Engineering Society">IEEE Oceanic Engineering Society</option> <option value="IEEE Photonics Society">IEEE Photonics Society</option> <option value="IEEE Power Electronics Society">IEEE Power Electronics Society</option> <option value="IEEE Power & Energy Society">IEEE Power & Energy Society</option> <option value="IEEE Product Safety Engineering Society">IEEE Product Safety Engineering Society</option> <option value="IEEE Reliability Society">IEEE Reliability Society</option> <option value="IEEE Robotics and Automation Society">IEEE Robotics and Automation Society</option> <option value="IEEE Signal Processing Society">IEEE Signal Processing Society</option> <option value="IEEE Society on Social Implications of Technology">IEEE Society on Social Implications of Technology</option> <option value="IEEE 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