Please fill in the information below and FAX your order. The administrator or authorized person of the school agrees to pay the American Mathematics Competitions for the following materials:

School Name		CEEB #__ __ __ __ __ __
Address
City	State	Zip
Teacher placing the order
AMC 10 Contest A Bundles of ten #_________ @ $13/bundle = $ A Solutions Sets of ten (optional) #_________ @ $ 6/set = $
AMC 12 Contest A Bundles of ten #_________ @ $15/bundle = $ A Solutions Sets of ten (optional) #_________ @ $ 6/set = $
Postage/handling Fee (see chart below) $ Total $ P.O. Number: Address: _____________________________ VISA/MC # : ____________________________________ Name (Please Print): Exp. Date:
AMC ORDERING -- TERMS 1. VISA and MasterCard accepted. FAX 402-472-6087 or 1-800-527-3690 2. Make checks payable to: American Mathematics Competitions Please Send Your Order To: American Mathematics Competitions ATTN: AMC 10/12 Additional Bundles P.O. Box 81606 Lincoln, NE 68501-1606 3. PAYMENT IN U.S. FUNDS ONLY. 4. U.S.A.: Order TOTAL Shipping Charge* $ 6.00 -- $40.00 $7.00 $40.01 -- $50.00 $9.00 $50.01 -- $75.00 $12.00 $75.01 -- UP $15.00 *Orders after January 18th add $5.00 additional for 2-day UPS. Orders after January 25th add $10.00 additional for 1-day UPS
Proof of Intent to Pay This document is intended to be used in lieu of pre-payment when calling or faxing in an order. Please indicate if you wish to be billed or will be sending a "check in the mail" (to be received within 2 weeks of order or you will be billed). Mail orders not wishing to be billed should include a check when returning this form. The person who signs this form must be authorized to pay the order that is placed by the teacher. BILLED Name of Person Authorized to Pay (please print): ______________________________________________ Signature:____________________________________________________________________________ Title: ___________________________________________________ Date: __________________ Cover Letter to Teacher Contents Changes I-Eligibility II-Team Score III-Braile/Large Print IV-Prelim. Instr. V-Sickness/Special Situ. VI-Int'l Students VII-"Day of" Instructions VIII-Policy IX- Results X-AIME XI-USAMO XII-MOSP XIII- Regions XIV- Awards XV-Contest A Certifi. Service Questionaire XVI-Add. Bundles F. XVII-2005 Reg. - Contest B XVIII-Rescoring Form XIX-10A Front Cover XX-12A Front Cover XXI-10 Practice Quest. XXII-12 Practice Quest. XXIII-Ltr to Parents XXIV-10 Partici. Certificates XXV-12 Partici. Certificates XXVI-Publicity XXVII-Sponsors
This AMC Web Page was last updated on 12/3/2004