2021 Regional Registration Form
Please complete this form to register your students for the Region 3 Texas Citizen Bee to be held at 4:30 PM on April 6th 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 April 7th at 4:30 PM.
* Required
Teacher/Sponsor Information
Name:
*
Your answer
Home Address
*
Your answer
City
*
Your answer
Zip code
*
Your answer
Teacher/Sponsor T-Shirt Size
*
Choose
Small
Medium
Large
XLarge
XXLarge
3XL
4XL
5XL
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.
Your answer
Home Email Address
*
Your answer
School Email Address
*
Your answer
School/Home School Name
*
Your answer
School/Home School Address
*
Your answer
Principal's Name
*
Your answer
School/Home School District
*
Your answer
Student Contestants
Please list the names of the students you will bring to the regional competition.
Student #1 Name
Your answer
Student #1 Email
Your answer
Student #1 T-Shirt Size
Choose
Small
Medium
Large
XLarge
2XL
3XL
4XL
5XL
Student #1 Phone Number (only used if technical difficulties arise).
Your answer
Student #2 Name
Your answer
Student #2 Email
Your answer
Student #2 T-Shirt Size
Choose
Small
Medium
Large
XLarge
2XL
3XL
4XL
5XL
Student #2 Phone Number (only used if technical difficulties arise)
Your answer
Student #3 Name
Your answer
Student #3 Email
Your answer
Student #3 T-Shirt Size
Choose
Small
Medium
Large
XLarge
2XL
3XL
4XL
5XL
Student #3 Phone Number (only used if technical difficulties arise)
Your answer
Student #4 Name
Your answer
Student #4 Email
Your answer
Student #4 T-Shirt Size
Choose
Small
Medium
Large
XLarge
2XL
3XL
4XL
5XL
Student #4 Phone Number (only used if technical difficulties arise)
Your answer
Student #5 Name
Your answer
Student #5 Email
Your answer
Student #5 T-Shirt Size
Choose
Small
Medium
Large
XLarge
2XL
3XL
4XL
5XL
Student #5 Phone Number (only used if technical difficulties arise)
Your answer
Student #6 Name
Your answer
Student #6 Email
Your answer
Student #6 T-Shirt Size
Choose
Small
Medium
Large
XLarge
2XL
3XL
4XL
5XL
Student #6 Phone Number (only used if technical difficulties arise)
Your answer
Student #7 Name
Your answer
Student #7 Email
Your answer
Student #7 T-Shirt Size
Choose
Small
Medium
Large
XLarge
2XL
3XL
4XL
5XL
Student #7 Phone Number (only used if technical difficulties arise)
Your answer
Student #8 Name
Your answer
Student #8 Email
Your answer
Student #8 T-Shirt Size
Choose
Small
MEd
Large
XLarge
2XL
3XL
4XL
5XL
Student #8 Phone Number (only used if technical difficulties arise)
Your answer
Student #9 Name
Your answer
Student #9 Email
Your answer
Student #9 T-Shirt Size
Choose
Small
Medium
Large
XLarge
2XL
3XL
4XL
5XL
Student #9 Phone Number (will only be used if technical difficulties arise)
Your answer
Student #10 Name
Your answer
Student #10 Email
Your answer
Student #10 T-Shirt Size
Choose
Small
Medium
Option 3
X
2XL
3XL
4XL
5Xl
Student #10 Phone Number (only used if technical difficulties arise)
Your answer
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