www.mathkangaroo.org

MATH KANGAROO in USA 2008 - MAIL REGISTRATION FORM

LOCATION:  see www.mathkangaroo.org or check with your school

Location Name:                                     City/Town:                            State:

LEVEL OF PARTICIPATION (SCHOOL GRADE OR HIGHER)_____________

FIRST NAME_______________________________________MIDDLE INITIAL_______

LAST NAME_______________________________________________________________

HOME ADDRESS__________________________________________________________

CITY/STATE/ZIP___________________________________________________________

PHONE(S)_____________________________________________________

PARENT’S EMAIL ADDRESS_____________________________________________

SCHOOL NAME____________________________________________________________

SCHOOL ADDRESS____________________________________________________________

CITY/STATE/ZIP___________________________________________________________

PRINCIPAL’S/TEACHER’S EMAIL________________________________________

RACE: __ASIAN ___BLACK ___HISPANIC ___NATIVE AMERICA  ___WHITE (optional) ;         

T-SHIRT (Adult Sizes): __X-SMALL OR  __SMALL OR  __MEDIUM  OR __LARGE OR __X-LARGE

IS FINANCIAL AID REQUESTED? __NO __YES (IF YES, PROOF OF NEED IS REQUIRED)

HOW MANY TIMES HAVE YOU TAKEN PART IN “MATH KANGAROO”  SO FAR? _______

Photographs will be taken during all Math Kangaroo events. All pictures

might be used for publishing on the web site, advertising, etc. If you do not

wish your child be photographed, please contact us.

Register on www.mathkangaroo.org and save on postage or

Mail this form with suggested donation of $20

(checks/money orders) payable to Math Kangaroo in USA, NFP

to:

Math Kangaroo in USA, NFP

P.O. Box 472

Lisle, IL 60532

Registration ends December 15th  2007

www.mathkangaroo.org