ACM LECTURESHIP SERIES

TRAVEL AUTHORIZATION FORM (rev. 6/94)
 
FOR USE BY: ACM Lecturers
 
SUMMARY: This form is to be used by the Lecturer to request 
travel authorization for a lecture tour.  This form is to be 
submitted only after the details of the tour have been agreed to 
by both Lecturer and chapters (see "Lecturer Request Form" 
elsewhere in this guide).

1. LECTURER: 

2. CHAPTER INFORMATION

a. Lecture 1:
i. Chapter name:
ii. Chapter contact (name, Email and phone):
iii. Lecture date:
iv. Expected Audience:

b. Lecture 2:
i. Chapter name:
ii. Chapter contact (name, Email and phone):
iii. Lecture date:
iv. Expected Audience:

c. Lecture 3:
i. Chapter name:
ii. Chapter contact (name, Email and phone):
iii. Lecture date:
iv. Expected Audience:

d. Lecture 4:
i. Chapter name:
ii. Chapter contact (name, Email and phone):
iii. Lecture date:
iv. Expected Audience:

3. ESTIMATED EXPENSES:

4. EVENT INFORMATION

a. Have the chapters agreed to adequately advertise your 
     lectures? (y/n/?)
b. Have the chapters agreed to cover local expenses? (y/n/?)
c. Are you satisfied with the coordination of the lecture tour? 
     (y/n/?)

Send this form to:

    lectureship@acm.org
       -- or --
    Association for Computing Machinery
    attn: Lectureship Series
    1515 Broadway
    New York, NY 10036
    vox: (1)-212-869-7440    
    fax: (1)-212-944-1318