Prime Factor Math Circle Registration Form (2012-2013 school year)
Parents, please use this form to register your students for the Prime Factor Math Circle.
Fill in all the required fields. Hit the "Submit" button when you are done. Send an email to info@pfmathcircle.org (you are not registered unless you received a confirmation from us). If you are registering several students, please fill out a separate form for each child.
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Student's Name (First, Last) *
Student's age and grade at school *
Student's school *
Registration is for *
Parent(s) name(s) *
Parent's daytime contact phone(s) *
Parent's evening contact phone(s) *
Parent(s) contact email(s) separated by semicolons *
Home address *
Emergency contact other than parent (name and phone number) *
Child's allergies and medical info, as needed
How did you hear about us? *
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