Please copy this form to your local machine, fill it out, print, and mail in with your check.
Please fill in all relevant
portions of this box. Please type or print.
o New Membership o Membership Renewal o Change/Correction
Name (last, first): __________________________________________________
Employer: __________________________________________________
Street Address: __________________________________________________
City, State, ZIP: __________________________________________________
Email Address: ___________________________________________________
Work Phone: (_____)______-______x______
Home Phone: (_____)______-______
Mailing address is:
o Work (Employer name will appear on mailing label.)
o Home (Employer name will not appear on mailing label.)
Membership Category:
o Regular member ($10) ACM Membership Number: _____________
o Corporate member ($11)
o Student member ($5)
Name of Institution: _____________________________
Faculty Signature: _____________________________
Please indicate your interest in the following:
o Working with the volunteers who lead the chapter
Joining one or more Special Interest Groups:
o SIGAda
o SIGAPL
o SIGCHI
o SIGDA
o SIGGRAPH
o Data Mining SIG
Make check payable to San Francisco Bay ACM, and mail to:
San Francisco Bay Chapter, ACM
P. O. Box 60355
Sunnyvale, CA 94088