2021 Regional Registration Form
Please complete this form to register your students for the Region 19 Texas Citizen Bee to be held at 4:00 PM on March 26th for the written exam There is no limit to the number of students that can register to take the written test. If you need more than the ten allowed on this form, contact jworst@cutx.org. Only the top 10 written scores will advance to the oral competition March 29th at 4:00 PM.
Teacher/Sponsor Information
Name: *
Home Address *
City *
Zip code *
Teacher/Sponsor T-Shirt Size *
Phone Number *
Please provide the best number (preferably a cell phone) to reach you if we have questions about your registration and on the day of competition if needed.
Home Email Address *
School Email Address *
School/Home School Name *
School/Home School Address *
Principal's Name *
School/Home School District *
Student Contestants
Please list the names of the students you will bring to the regional competition.
Student #1 Name
Student #1 Email
Student #1 T-Shirt Size
Student #1 Phone Number (only used if technical difficulties arise).
Student #2 Name
Student #2 Email
Student #2 T-Shirt Size
Student #2 Phone Number (only used if technical difficulties arise)
Student #3 Name
Student #3 Email
Student #3 T-Shirt Size
Student #3 Phone Number (only used if technical difficulties arise)
Student #4 Name
Student #4 Email
Student #4 T-Shirt Size
Student #4 Phone Number (only used if technical difficulties arise)
Student #5 Name
Student #5 Email
Student #5 T-Shirt Size
Student #5 Phone Number (only used if technical difficulties arise)
Student #6 Name
Student #6 Email
Student #6 T-Shirt Size
Student #6 Phone Number (only used if technical difficulties arise)
Student #7 Name
Student #7 Email
Student #7 T-Shirt Size
Student #7 Phone Number (only used if technical difficulties arise)
Student #8 Name
Student #8 Email
Student #8 T-Shirt Size
Student #8 Phone Number (only used if technical difficulties arise)
Student #9 Name
Student #9 Email
Student #9 T-Shirt Size
Student #9 Phone Number (will only be used if technical difficulties arise)
Student #10 Name
Student #10 Email
Student #10 T-Shirt Size
Student #10 Phone Number (only used if technical difficulties arise)
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