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2004 USAMO Teachers Manual -S-III -- Student/Parent Response Form
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2004 USAMO Teachers Manual
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S-III -- Student/Parent Response Form
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This Form must be completed by each USAMO student and his or her parent/guardian and returned by FAX 303/374-6339 (Emergency FAX 402/472-6087) or mailed to the AMC Office so that it is received on or before April 21.
Complete all items carefully.
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Section A- USAMO Participant High School Certification
I certify that my last month as a regular high school student, either due to graduation or to early enrollment in a college degree program, will be no sooner than _______________(Month and year).
Students who are not citizens of the USA are eligible to participate in the USAMO only if they are permanent residents* of this country.
CITIZENSHIP Status: USA Citizen_____ *Legal Resident______
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| Date of Birth: ____________________ |
Place of Birth______________________ |
Signed: ______________________________________
USAMO Participant |
Date:_____________________ |
Verified by:___________________________________
Parent/Guardian |
Date:_____________________ |
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Section B - USAMO/IMO PARTICIPATING STUDENT
(American Citizen or Legal Resident)
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I have read the "Instructions to Participate-Form S-II" and my teacher has made arrangements for me to take the USAMO on Tuesday, April 27, 2004 and Wednesday April 28, 2004.
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#1
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#1 Circle one: If invited, I (am or am not) willing to attend the 2004 Mathematical Olympiad Summer Program (June 13-July 3) |
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#2 Circle one: If invited, I (am or am not) willing to serve as a USA Team Member at the IMO, July 9-19, 2004 in Athens, Greece. |
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| Signature:_____________________________ |
Date:_____________________ |
| Home phone(_____)____________________ |
Email:___________________________ |
Full Name (please print, including initial):
____________________________________________________________________ |
| May/June Mailing Address: _______________________________________________ |
| _________________________________________________Zip: ________________ |
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