UPE/ACM STUDENT CHAPTER SCHOLARSHIP AWARD APPLICATION

Upsilon Pi Epsilon
Honor Society for the Computing & Information Disciplines

&

Association for Computing Machinery (ACM)

the First Society in Computing

UPE and the ACM wish to encourage academic excellence for students in the computing and information disciplines. UPE initiated this
award with ACM I order to raise the importance of academic achievement and professional commitment to ACM student members who are
about to enter the computing profession.

Who is Eligible? All graduate and undergraduate students (past 12th grade, college-level and above), who are ACM members and also
members of the ACM Student Chapter at their academic institution. An applicant must be enrolled or registered as a regular student and be
an ACM student member when awards are announced in Fall 2021.

Criteria? ACM student members who are full-time students, and members of an ACM Student Chapter at an
academic institution. The primary judging categories for these two awards are the applicant’s academic records
(official transcripts must be attached to each application), the tone of the faculty member’s recommendation, and the
applicant’s department-related activities. Questions related to these awards can be directed to UPE at upe@acm.org.

How to Apply? Complete this application form, and mail it, along with the items listed below to:

ACM/UPE Scholarship Award

c/o Upsilon Pi Epsilon
158 Wetlands Edge Road
American Canyon, CA 94503
USA

Please type or write clearly and plainly in black ink. Applications are due on July 1, 2021.

Name___________________________________ACM Member #___________________

Permanent mailing address__________________________________________________
________________________________________________________________________
Email address____________________________________Phone____________________
Name and address of academic Institution________________________________________
________________________________________________________________________
________________________________________________________________________
Name of ACM Chapter Faculty Advisor__________________________________________
Advisor’s Email Address___________________________________Phone_____________________

Grade Point Average______Grade %____

1. Overall grade point average_____out of a possible___
2. Student rank____out of class of_______
3. Computing (classes) grade point average__ out of a possible___

Submit the following documents along with this application:

1. Two letters of recommendation from the student’s CS- or IT-related faculty or ACM Student Chapter Advisor.
2. A certified copy of the previous three years (minimum) official academic/college transcripts.
3. A statement of your participation in the ACM Student Chapter at your academic institution.

To the best of my knowledge, all information provided above is accurate and correct.

_____________________________________________ ________________
Signature of ACM Student Member Date

If you have any questions, please contact UPE at upe@acm.org.

For information on ACM Student Chapters, please visit http://www.acm.org/chapters/stu/
For complete information on UPE, please go to http://www.acm.org/upe/

NOTE: Incomplete applications will not be considered for this ACM/UPE Scholarship Award.