Chemistry Day Olympics

Registration Form:

School:
Mailing Address:
City:
State:
Zip Code:
Chemistry Teacher(s):
Work Phone:
Home Phone (Optional):
E-mail:
School Principal:
Hours of Availability:

Division I   
Division II  
Division III 

Will you be attending the lunch/round table discussion for teachers? If so, please include the $5.00 amount with your registration fee.

Yes
No 

Any changes in this status must be telephones in by April 22nd.

    Phone: (361) 593-2914 or (361) 593-

    A check made out to "Texas A&M-Kingsville: Chem Day Account" in the amount of your registration fee
    should accompany this form.  Registration fees are $45.00 for Division I competition, $35.00 for Division                 
    II competition, and $25.00 for Division III competition. Note: We realize that sometimes your business office can be 
    slow in producing a check for the registration fee. If that is likely to be the case, please SUBMIT or send us a copy of 
    this form without the fee so that we can properly prepare for the day.