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For additional information on this program please refer to the Guide for ACM Fellows Nominations

Nominations and endorsements must be submitted by September 15, 2009.

All information will be kept confidential within the Fellows Committee.
 
   Candidate
 
  Last (Family Name)
  First (Given Name)
  Middle (optional)
  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
 
   Home Address
    Same as Above
 
  Street
  City
  State/Province
  Zip/Postal
  Country