EDUCATORS' GRANT PROGRAM APPLICATION FORM
                     PLDI '99, Atlanta, GA, May 1-4, 1999


Name:
Institution:
Mailing Address:
E-mail address:
Phone:

If selected, may we include your name and above contact information in
a participants list to be distributed to the participants in the PLDI '99
Educators' Grant Program?


Courses Taught
--------------

1.  Please list the computer science courses that you have taught
    in the last two years:




2.  Please list the computer science courses that you expect to teach
    in the next two years.  Indicate which courses will benefit from
    your attending PLDI '99:




Female and Minority Students
----------------------------

3a. How many students you have taught in computer science courses
    during the last two years?

3b. Approximately what percentage of these students have been

    Female:
    Hispanic:
    African American: 
    American Indian or Alaska Native:
    Native Hawaiian or Other Pacific Islander:


4a. How many students do you expect to teach in computer science
    courses during the next two years?

4b. What percentage of these students do you expect to be

    Female:
    Hispanic:
    African American: 
    American Indian or Alaska Native:
    Native Hawaiian or Other Pacific Islander:



Grant Request
-------------

5.  Are you interested in attending only the tutorials, or both the
    tutorials and the conference?


Personal Data
-------------

6.  Indicate all that apply:

    U.S. Citizen:
    Permanent Resident:
    Non-U.S. Citizen:

    Female:
    Hispanic:
    African American:
    Asian:
    Caucasian:
    American Indian or Alaska Native:
    Native Hawaiian or Other Pacific Islander:


7.  Were you awarded a grant to attend:

    PLDI '94:
    PLDI '96:
    PLDI '97:


Statement of Purpose
--------------------

    Please attach a brief statement describing (A) your professional goals,
    (B) why attending the PLDI tutorials (and conference) will help
    you to achieve these goals, and (C) how this will help to improve
    the representation of women and minorities in computer science.



Travel Budget
-------------

    Please attach an estimated travel budget.  Note that the tutorial
    includes continental breakfast, lunch, and coffee breaks.  The
    conference includes three continental breakfasts, two lunches, an
    evening reception, coffee breaks, and a copy of the conference
    proceedings.  The conference hotel, the Atlanta Hilton & Towers will
    provide suites at the special conference rate of $135 - $155 per
    night.  To secure the conference rate, call 404-659-2000 and mention
    ``ACM.''  Delta airlines is also offering special rates for conference 
    attendees; call 1-800-241-6760 for details and refer to file 
    number 116944A.  For more details on hotel and travel arrangements,
    see the FCRC '99 web site at http://www.acm.org/sigs/conferences/fcrc/.

    To receive funds, participants will be required to submit after the
    conference both a completed evaluation form and a travel expense form
    with original receipts.  Full reimbursement will not be guaranteed
    if actual costs exceed the estimated costs by a significant
    amount.  The maximum allowable reimbursement under this program is
    $1,000 per participant.



Enclosures
----------

Please include the following with your application form:

* Statement of purpose
* Travel Budget
* Letter of endorsement from your department chair or dean
* Current curriculum vitae


Return the application by March 31, 1999 to:

    Jennifer Anderson
    Compaq Computer Corporation
    Western Research Lab
    250 University Ave
    Palo Alto, CA 94301
    jennifer@pa.dec.com

Grant recipients will be notified by April 5, 1999.