ACM CCS Workshops Student Travel Support Application

Name:

Workshop to Attend:

Postal Address:

Email:

Homepage URL:

ACM member number:
(or date of application, if you have not received your number yet)

University Enrolled:
Department:
Degree pursued:
When you expect to finish:

Faculty advisor
Name:
E-mail:

Have you previously received an ACM CCS Workshop travel grant?

ACM CCS workshop program participation
Are you an author of an accepted workshop paper(s), [list the titles]?

Will you be presenting the paper(s) [list the titles]?