Application Form

Fill-in the following information neatly and legibly. Information marked in * are required.

Renewal

If are renewing, indicate when you became a member for the first time.

Profile

* First name

* Last name

* Student Number (xxxx-xxxxx)

* Year

* Birthday

* Year of Graduation

* College

* Degree and Major

* Email Address

Web site http://

Home Phone

* Mobile Phone

Twitter

* Present Address

Permanent Address

Parents' Information

Mother's Name

» Occupation

» Contact Number

Father's Name

» Occupation

» Contact Number

Affiliations

Enumerate other organizations you are affiliated with, and indicate your position.

Organization	Position/s

* Preferred Committees

Rank your committee preference. Rank 1 is your most preferred committee. What does each committee do?

Special Interest Groups (SIGs)

Choose any number of preferred SIGs. It is recommended that you join all of them. What are Special Interest Groups?

Java

Games and Graphics

International Collegiate Programming Contest

ACM International

Are you a member of ACM International?

Yes

Do you want to join ACM International?

Yes

* Class Schedule

Describe your weekly class schedule, in this format:

Days (comma-separated) / Time Slot (12-hour format) / Subject

Separate multiple subjects by a newline. A sample has been provided below; replace the example with your schedule.

* UP ACM Web mail

Obtain a UP ACM Web mail (@upacm.net) account by entering your UP Web mail username (shortened form, e.g.: jpmontalbo) below.

@up.edu.ph

Referral

If you were referred to by a UP ACM member, indicate his/her name. Leave blank if nobody referred you to UP ACM.

Other requirements

Other than this application form, submit the following requirements on or before the deadline:

Four 1" x 1" ID Pictures
Three certified photocopies of latest Form 5 with UP ID (on the same paper)
PhP 100.00 annual membership fee to UP ACM (P90 for freshmen applying for this semester only)

If you are planning to join ACM International as a Student Member, submit this on top of the requirements above:

US$18 (PhP ~800) annual student membership fee to ACM International (special rate for Philippines)

Deadline of application and renewal is on June 30, 2008. No extensions, please.

Association for Computing MachineryUP Student Chapter