Registration Form

Sonya Kovalevsky Day Pre-registration form

Please print and fill in this form. If you wish to register more than 6 students, print and complete additional copies of the form, listing the adult chaperone for each group of 6. There is a $10 reservation deposit which will be refunded the day of the event. Please mail all forms with a check or money order for $10, made out to the AU Department of Mathematics and Statistics, to reach us by March 8, 2004. Send it to

Sonya Kovalevsky Day Registration
Department of Mathematics and Statistics
American University
4400 Massachusetts Avenue NW
Washington, DC 20016-8050

Teacher Name	. .
School Name	. .
Street Address	. .
City, State, and Zip	. .
Phone	. .	Email	.
Is email a reliable way to send you a confirmation and program details?					.
In the space below, please list up to 6 students who will attend, showing the name and the grade for each
Name				Grade
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