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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 208/978-9117 (Emergency FAX 402/472-6087) or mailed to the AMC Office so that it is received on or before April 23.
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_____ *Permanent Resident______
*Permanent resident is defined as someone seeking citizenship and currently possessing a U.S.A. Immigration "green card".
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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 Permanent 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 29, 2003 and Wednesday April 30, 2003.
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#1
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Circle one: If invited, I (am or am not) willing to attend the 2003 Mathematical Olympiad Summer Program (June 15-July 5) |
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Circle one: If invited, I (am or am not) willing to serve as a USA Team Member at the IMO, July 11-19, 2003 in Tokyo, Japan. |
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| Signature:_____________________________ |
Date:_____________________ |
| Home phone(_____)____________________ |
Email:___________________________ |
Full Name (please print, including initial):
____________________________________________________________________ |
| May/June Mailing Address: _______________________________________________ |
| _________________________________________________Zip: ________________ |
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