please print

School CEEB# (ETS, See section IV, 6 digits): ____ ____ ____ ____ ____ ____			BILLING ADDRESS (if different from school):
Contest Manager:
School Name:
School Street Address:
City:	State:	Zip:	City:	State:	Zip:
School Phone #: _____/______-____________			Phone #: _____/______-____________
E-mail (for sending results) Please Print Clearly:
School Type (circle one):			Grades:
Public	Home	Private	5 6 7 8 9 10 11 12 13

REGISTRATION FEE (for one contest or both! Use rate chart below) REQUIRED (No registrations after February 15, 2003)
	Early Registration, By Dec. 15	$30	$ __________
	Registration, Dec. 16 - Jan. 15	$40
	Late Registration, Jan. 16 - Feb. 15	$50 ( fax please)
AMC 10	Contest Bundles of 10 exams and answer forms	#_________ @ $ 12/bundle =	$ __________
	Solutions Sets of 10 pamphlets (optional)	#_________ @ $ 6/set =	$ __________
AMC 12	Contest Bundles of 10 exams and answer forms	#_________ @ $ 14/bundle =	$ __________
	Solutions Sets of 10 pamphlets (optional)	#_________ @ $ 6/set =	$ __________
Shipping — (First Class/UPS Shipping and Handling:) REQUIRED. (choose 1 below)
	United States and Military Schools:	$ 12.00 flat fee	$ __________
	Canadian Schools: (Shipping by DHL)	$ 15.00 flat fee
	Foreign Schools:.	# _________@ $ 5.00 per bundle (with a $60 maximum)
OPTIONAL: (Foreign Schools Only): The MAA AMC office will send results by Express Mail for a $25 fee			$ __________
PAYMENT OPTIONS (Do not send payment alone. The Registration Form must be included with your payment option) Checks sent without appropriate registration information cannot be processed and will be returned to sender.
Check P.O. # _______________ Visa Master Card American Express
TOTAL ORDER – MUST BE PAID IN US FUNDS			$ __________

Make checks payable to: AMERICAN MATH COMPETITIONS	Mail along with your payment or Purchase Order to: MAA American Mathematics Competitions ATTN: AMC 8 Registration P.O. Box 81606 Lincoln, NE 68501-1606 After January 15 registrations will be taken by FAX
CREDIT CARD INFORMATION:
Card #: ____________________________
Cardholder Name (please print):
Exp. Date:
Address: __________________________________________________
__________________________________________________