Petition for Charter Chapter

To: The Local Activities Board of the Association for Computing Machinery

We, the undersigned, who are Members in good standing of the Association for Computing Machinery (ACM) or of an ACM Special Interest Group, do hereby submit a request for recognition of the undersigned as charter members of BuckCHI, the Central Ohio Special Interest Group on Computer-Human Interaction Chapter of the ACM to serve members in central Ohio. We request recognition and approval as an official chapter. Interim officers are as noted below:

Member Number             Name           Office              Signature

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All officers must be members of the ACM.

This petition and your chapter bylaws should be submitted in duplicate to:

	ACM-Local Activities
	1515 Broadway
	New York, NY 10036
Concurrent membership applications, with payment dues, should be submitted in the same envelope.

Questions about chapter formation can be directed to:

	Fran Sinhart
	ACM Local Activities Chapter Coordinator
	sinhart@acm.org
	+1-212-626-0514