IN, MI & OH CENTER ~ 2019-2020 MP School Contact Designee (SCD) Form
To better serve your school we ask that you complete the following information to designate an official Math Pentathlon® Contact Person who will be the primary representative for your school. The Contact Person will receive all communication from the Pentathlon Institute to share with others. The school contact must be approved by the school principal unless this is a club that does not practice at a school. If approved, the contact may access their preliminary tournament database.
Email address *
Is the School Contact Designee (SCD) the same this year as last year? *
Is the Principal the same this year as last year? If none, please indicate none. *
Required
School District (if none, please indicate none): *
School Name (if none, please indicate none): *
Math Pentathlon Games are taught in: *
Your Position (select all that apply): *
Required
First & Last Name of School Contact Designee (SCD): *
School Contact Designee (SCD) Email: *
School Contact Designee (SCD) Daytime Phone: *
School Contact Designee (SCD) Evening Phone:
First & Last Name of Principal (if none, please indicate none): *
Principal's Email (if none, please indicate none@none.org): *
School or Club street address: *
School or Club city: *
School or Club state: *
School or Club zip code: *
School or Club phone: *
School fax:
School or Club Website:
Our students: *
Approximately how many Div I (Kinder/1st Grade) Pentathletes® will your group be sending to the tournament? If zero, please enter 0. *
Approximately how many Div 2 (2nd/3rd Grade) Pentathletes® will your group be sending to the tournament? If zero, please enter 0. *
Approximately how many Div 3 (4th/5th Grade) Pentathletes® will your group be sending to the tournament? If zero, please enter 0. *
Approximately how many Div 4 (6th/7th Grade) Pentathletes® will your group be sending to the tournament? If zero, please enter 0. *
By entering Principal name and date below, the electronic entry is considered a signature. Please note that all Principals will be contacted to verify this information.
Date: *
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DD
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YYYY
Principal Signature (if none, please indicate none): *
This section is for sharing information with the institute (Comments, Student Quotes, Praise, Suggestions, etc).
A copy of your responses will be emailed to the address you provided.
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