27th Annual Great Computer Challenge 2012 - Registration Form
Senior Competition (grades 6-12) - March 17, 2012
DEADLINE - Feb 17th, 2012 - $50 late fee if postmarked after this date.

Junior Competition (grades K-5)- April 28, 2012
DEADLINE - March 30th, 2012 -$50 late fee if postmarked after this date.

Make sure you use the hard copy to prepare your data before submission, to have a record for yourself, and to mail or email in with your payment. http://www.whro.org/cii/documents/gcc/gccreg_2012.doc

Please take a few minutes to fill out this form. If you are paying by credit card, please list it on the worksheet and mail or email it in or call 886.559.2353. If you are mailing a PO or check, make sure you mail or email it with your worksheet.

EMAIL - gcc@whro.org
MAIL - WHRO/GCC
5200 Hampton Blvd
Norfolk, VA 23508

Register ONLY ONE team per form. One team per school per category per level! (except for teams with *)

You can find the GCC FAQ's here. http://www.whro.org/cii/gcc/faq.asp

You can visit http://www.whro.org/cii/mem.asp to check membership. If your school or school division is listed, you are considered either a C.I.I. Member or a C.I.I. Service Participant.
Choose Your Memebership Level - you can visit http://www.whro.org/cii/mem.asp to check membership. If your school or school division is listed, you are considered either a C.I.I. Member or a C.I.I. Service Participant. *
Required
Choose Your Level *
Required
Choose Your Category - Register only one team per form. One team per school per category per level! (except for teams with *) *
Required
Computer Type
Software/Version
Your answer
Teacher Coach First Name *
Your answer
Teacher Coach Last Name *
Your answer
Teacher Coach First Name 2 (if more then 1 coach)
Your answer
Teacher Coach Last Name 2 (if more then 1 coach)
Your answer
Teacher Coach First Name 3 (if more then 2 coaches)
Your answer
Teacher Coach Last Name 3 (if more then 2 coaches)
Your answer
Teacher Coach First Name 4 (if more then 3 coaches)
Your answer
Teacher Coach Last Name 4 (if more then 3 coaches)
Your answer
School *
Your answer
School Division *
Your answer
School Address *
Your answer
School City *
Your answer
School State *
Required
School Zip *
Your answer
School Phone *
Your answer
Home Phone
Your answer
School Fax
Your answer
Email address *
Your answer
Cell Phone
Your answer
Team Members
Up to three students for Level 1, 2, & 3. Up to five students for Level 4. If you don't have the names at the time of registration, please email them to gcc@whro.org.
Team Member 1
Your answer
Team Member 2
Your answer
Team Member 3
Your answer
Team Member 4 (only for Level 4)
Your answer
Team Member 5 (only for Level 4)
Your answer
T-shirt Order
Each team member (not including the teacher coach or alternates) will receive a T-shirt covered by the registration fee. Please indicate # of each size.
Small (youth size)
Your answer
Small (adult size)
Your answer
Medium (adult size)
Your answer
Large (adult size)
Your answer
XL (adult size)
Your answer
XXL (adult size)
Your answer
XXXL (adult size)
Your answer
Pre-Order extra shirts
Teachers may order additional T-shirts @ $10.00 prepaid. Please indicate how many additional shirts you would like to order.
Small (youth size)
Your answer
Small (adult size)
Your answer
Medium (adult size)
Your answer
Large (adult size)
Your answer
XL (adult size)
Your answer
XXL (adult size)
Your answer
XXXL (adult size)
Your answer
PreOrder Totebags
Teachers may also order Great Computer Challenge. Tote Bags @ $10.00 prepaid.
# of totebags
Your answer
PreOrder DVD of GCC School Talk Special
Great Computer Challenge and Winners are highlighted in School Talk. @ $10.00 prepaid.
# of DVDs
Your answer
Final Payment Total
Choose the Level you are registering for - the cost is per team and based on membership and team level. You can visit http://www.whro.org/cii/mem.asp to check membership. If your school or school division is listed, you are considered either a C.I.I. Member or a C.I.I. Service Participant. *
Required
Total amount of extra T-shirts, totebags, DVDs (all are $10.00/each) *
Your answer
Method of Payment
Please choose your method of payment. Note your category and level on your check or PO.
Please choose your method of payment *
Check#/PO#
Your answer
Total to be paid *
Your answer
Comments/Questions (Include any special needs here - i.e. wheel chair ramp for awards ceremony)
Your answer
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