ACM Professional Chapters Technical Meeting Profile

Public Information (for publication in appropriate events calendars):
Name of event:
Acronym (if any):
Dates/Time of Event:
Proposed Location/Facility:
City:
State:
Country:

Summary of Technical Program:

Contact person for more information:
Name:
Volunteer position:
Mailing address:
Phone:
Fax:
Email:

Sponsorship: Check One: __Sponsored/Co-sponsored  __In cooperation
Sponsoring ACM Subunits:
_______ % Sponsorship
_______ % Sponsorship
_______ % Sponsorship
Other Sponsors:
_______ % Sponsorship
_______ % Sponsorship
_______ % Sponsorship

Please return this form to:

        Program Director Local Activities
        ACM Headquarters
        1515 Broadway
        New York, NY 10036
        212-626-0514 (phone)
        212/944-1318 (fax)
        chapters@acm.org

Please email copies to:

        chapters@acm.org	212-626-0514

*** Not for Publication - For Internal Use Only ***

How likely are you to want assistance with:
(H)Highly Likely     (P)Possibly     (N)Not Likely
___ Publicity (CACM, Local Events Cal.)
___ Financial assistance
___ Facilities planning suggestions
___ Mailing labels
___ Contract review
___ Budget review

For the last previous occurrence (complete if regularly held):
Date:
Actual attendence:
Registration fees:
Members:                (early)         (on-site)
Nonmembers:             (early)         (on-site)
Total actual income:
Total actual expense:
____ Check if part of a series (PDS series, etc.)

Dates of other sessions:
For the proposed event:
Estimated attendence:
Estimated registration fees:
Members:                (early)         (on-site)
Nonmembers:             (early)         (on-site)
Total estimated income:         Total estimated expense:

Will the event include the following (check all that apply):
___ Advance Program
___ Call for Participation
___ Conference Management
___ Exhibits
___ Final Program
___ Proceedings
___ Social Functions
___ Tours/Special Events
___ Tutorials (In addition to main technical program)
___ Workshops (In addition to main technical program)

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