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2016-17 School/Association Winners HCLS Spelling Bee Registration Form
Please refer to the family emergency card for the most accurate data and correct spelling. Information will be used for all Spelling Bee mailings and participant certificates.
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* Indicates required question
School:
*
Your answer
School Bee Winner
Name:
*
Your answer
Grade:
*
Your answer
D.O.B.
*
Your answer
Parent/Guardian
*
Your answer
Home Address:
*
Your answer
City:
*
Your answer
State:
*
Your answer
Zip:
*
Your answer
Phone:
*
Your answer
Race
*This data is collected for survey purposes only and will be kept confidential.
Your answer
Email:
*
Your answer
School Bee Alternate
Name:
*
Your answer
Grade:
*
Your answer
D.O.B.
*
Your answer
Parent/Guardian
*
Your answer
Home Address:
*
Your answer
City:
*
Your answer
State:
*
Your answer
Zip:
*
Your answer
Phone:
*
Your answer
Race
*This data is collected for survey purposes only and will be kept confidential.
Your answer
Email:
*
Your answer
PLEASE SUBMIT THIS INFORMATION BY JANUARY 27, 2017.
Questions? Please contact:
Kelli Shimabukuro
Community Education and Partnerships Coordinator Howard County Library System
9411 Frederick Road
Ellicott City, MD 21042
kelli.shimabukuro@hclibrary.org
410.313.7750
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