ACM Badge Pickup Form
You do not have to fill out every badge section if you are only applying for certain badges.
You may submit this form multiple times as you apply for and earn different badges (no duplicates, please!).

Sticker applications will be reviewed prior to distribution after general meetings.
If you cannot pick up the badges after general meetings, contact Janine Huang at
First Name *
Last Name *
UCR Email *
Never submit passwords through Google Forms.
This form was created inside of ACM Student Chapter at UCR. Report Abuse