Distinguished Member Nomination

Educational Institution

Year (yyyy)

Major Discipline

For additional information on this program, please refer to the nomination instructions.

Self-nomination is not permitted. Nominations and endorsements must be submitted by 01-AUG-2024.

All information will be kept confidential within the Distinguished Member Committee.

Candidate

	First (Given Name)
	Middle (optional)
	Last (Family Name)
	Email
	Phone
	Fax
	Present Occupation
	Organization
	Organization Type
	Date of Birth (mm/dd/yyyy)
	Gender	Male Female Prefer not to provide
	ACM Member No.
	--or--
	Username

Business Address

	Street
	City
	State/Province
	Zip/Postal
	Country/Region

Home Address

Same as Above

	Street
	City
	State/Province
	Zip/Postal
	Country/Region

Concise Statement of Key Achievement (75 characters or less)

Accomplishments (4,000 characters or less)

Since the data contained in the nomination is the Distinguished Member Committee's key source of information on the candidate, it is essential that the qualifications be described thoroughly, concisely and objectively, stating the significance of the candidate's accomplishments to the discipline and to society.

Education (List Highest Degree First)

Education: If necessary, enter information to further explain the Candidate's education. (1,000 characters or less)

Professional Experience: List current position first.
If currently employed, enter current year (i.e. 2006.)

	Start Year (yyyy)	End Year (yyyy)	Name of Organization	Position Held
1
2
3

Select Technical Area Categories
Please check all that apply to the Candidate's body of work

Candidate's CV
Please attach file with Candidate's CV (only PDF format will be accepted)

Algorithms
Artificial Intelligence
Biotech
Complexity
Computation
Computational Geometry
Computer Architecture
Cryptography
Data Mining
Databases
Design Automation
Education
Embedded Systems
Graphics
High Performance Computing
Human Computer Interaction
IT
Information Retrieval
Knowledge Management
Language Processing
Measurement
Mobile Computing
Modeling
Multimedia
Networking
Operating Systems
Programming Languages
Robotics
Search
Security
Software Engineering
Spatial Information
Virtual Reality
Vision
Web
Wireless Systems

Nominator

	First (Given Name)
	Middle (optional)
	Last (Family Name)
	Relationship to Nominee
	ACM Member No.
	Email
	Organization
	Street
	City
	State/Province
	Zip/Postal
	Country/Region
	Phone
	Fax

I understand that ACM will investigate and verify the educational and employment data provided in this nomination. I authorize investigation of all statements contained in this nomination. I understand that misrepresentation or omission of facts contained herein will cause the nomination to be rejected.