2012 – 2013 Mathematics Challenge for Filipino Kids Training Program

Registration Form

Center: ________________________________

Date:                                                              

Family Name, First Name, Middle Name :__________________________________

Birthday:                                   Contact Nos.:                                                   

email address:                                                           

Home Address: ____________________________________________________

Passport No.:                           Expiry Date:                                                              

School:                                                                                                                                                                                                                                                                                                                        

School Address:                                                                                                                                                                                                                                                                                              

Name of Head of School:                                                                                                                                

Position:                                                                                                            

Name of Math Coordinator or Math Department Head:                                                                                                                                                     

Name of Parents:

Father:                                                             Contact No.:                                                                                      

Mother:                                                            Contact No.:                                                                                       

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         Trainee's Signature