SIGSOFT CAPS Application Form

To use this form, simply download it in text form, fill it in and email the completed form to sigsoft_caps@acm.org. Also send a resume and supporting note from your advisor or department chair. You may also submit this form online.

Application Category:
	Merit-based __________ or Need-based ___________


Name: _________________________________________

E-mail address: _____________________________

Are you currently a student _______
         PH.D. program  ________ or  Masters Program _________ or Bachelor Program __________

Year entered school: _______________

University or College: ______________________________________

Country where University is located: ________________________________

Department: _________________________________

Department chair name: _________________________

Department chair email address: _________________________

Adviser name: _________________________

Advsior email address: _________________________

Are you a member of SIGSOFT? ____ Give  your membership number _________

For what SIGSOFT sponsored conference are you requesting travel funds?

________________________________________________

Where and when will it be held?____________________________

Are you the author of a paper at the conference?____________

Title of the paper: ________________________________________________

Type of paper (technical, poster, doctoral symposium, workshop (please
identify which workshop), etc.): _______________________________________

Will you present the paper? _____________________

Are you involved in any  other way with the conference?  e.g., posters ______
  if so, how?

Please list your estimated expenses below. You should try to get the
least expensive air fare, hotel room, etc.

	Funds			Explanation

Travel      US$__________		___________________________________________

Hotel       US$__________		___________________________________________

RegistrationUS$__________		__________________________________________


TOTAL Funds needed  US$ ___________

The CAPS program can only provide partial support for student attendance. Please seek funds from research grants that support your research, your department, and your University/College.

What funds do you have available?

   From your university or college  US$ ___________

   From your department US$ ____________

   From your research grant US$ ___________

   Other  US$ _______________   Source of funding ____________________

   TOTAL Funds Available US$ ____________

How much are you requesting from SIGSOFT CAPS?  US$ _________