Registration Form
Twenty Third Annual Math And Science Bowl
November 17, 2011
West Virginia University Institute of Technology

Name of School: __________________________________

Address:             __________________________________

                          __________________________________

Phone/Fax Numbers: __________________________________

Team Members:                                                         Grade

         ________________________________(Captain) _____

        ________________________________                 _____

        ________________________________                 _____  

        ________________________________                 _____

        ________________________________(Alternate) _____

Name of Team Sponsor: _____________________________  Title:___________________

E-mail address: _____________________________

School Phone  # : ___________________  Home Phone #: _____________________

Best time to reach you: _____________________________

Name of School Principal: ____________________________

Please return this form by Oct 31, 2011. Names can be changed after this date, but for planning purposes I would like to know how many people will be attending our event. (Any name changes made after Nov. 10^th might not appear in the program)

If there are any questions, please contact Susan Barton at one of the numbers below.
WVU Tech: 442-3297 , e-mail: sbarton@wvutech.edu
You may also leave a message with the Math Department Secretary at 442-3361.