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<title>Team Roster form</title>

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<table align="center" border="0" width="100%">

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<td colspan="8"><h1>MATHChallengers British Columbia</h1></td>
</tr>

<tr align="center">
<td colspan="8"><h2>Team Roster Registration Form</h2></td>
</tr>

<tr align="center">
<td colspan="8"><hr width=90% height=5></td>
</tr>

<tr align="center">
<td colspan="8"><h3>Regional Competitions</h3></td>
</tr>

<tr align="center">
<td colspan="8">Vancouver Island: Friday, February 17, 2006</td>
</tr>

<tr align="center">
<td colspan="8">Lower Mainland: Saturday, February 18, 2006</td>
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<tr align="center">
<td colspan="8">&nbsp;  </td>
</tr>

<tr align="center">
<td colspan="8">Please complete this Team Roster Registration Form and submit it by Friday, January 27, 2006</td>
</tr>

<tr align="center">
<td colspan="8">&nbsp;  </td>
</tr>

<tr align="center">
<td colspan="8">Please select the division in which your team will be participating.</td>
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</table>

<form name = "TeamRegForm" method="post" runat="vdaemon" action="http://www.apeg.bc.ca/MathChallengers2/Forms/processTReg.php">

<table align="center" border="0" width="100%">

<tr align="center">
<td>&nbsp;  </td>
<td>&nbsp;  </td>
<td>&nbsp;  </td>
<td>&nbsp;  </td>
<td align="right"><input type = "radio" name = "division" value="Fraser North"></td>
<td align="left">:Lower Mainland </td>
<td>&nbsp;  </td>
<td>&nbsp;  </td>
</tr>

<tr align="center">
<td>&nbsp;  </td>
<td>&nbsp;  </td>
<td>&nbsp;  </td>
<td>&nbsp;  </td>
<td align="right"><input type = "radio" name = "division" value="Vancouver Island"></td>
<td align="left">Vancouver Island</td>
<td>&nbsp;  </td>
<td>&nbsp;  </td>
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<td colspan="8">&nbsp;  </td>
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<td colspan="8">Please provide the following contact information:</td>
</tr>

<tr align="left">
<td>Coach(es)</td>
<td colspan="7" align="left"><input name="CoachName" size="85"></td>
</tr>

<tr align="left">
<td>School Name</td>
<td colspan="7" align="left"><input name="SchoolName" size="85"></td>
</tr>

<tr align="left">
<td>Work Phone</td>
<td colspan="7" align="left"><input name="WorkPhone" size="85"></td>
</tr>

<tr align="left">
<td>E-mail</td>
<td colspan="7" align="left"><input name="ContactEMail" size="85"></td>
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<tr align="left">
<td colspan="8">&nbsp;  </td>
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<tr align="center">
<td colspan="8"><hr width=90% height=5></td>
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<td colspan="8"><b>Grade 8 Team # 1</b></td>
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<tr align="left">
<td colspan="8">Enter the names of the individuals comprising your Grade 8 Team #1:</td>
</tr>

<tr align="left">
<td colspan="8" align="left"><input name="Grade811" size="85"></td>
</tr>
<tr align="left">
<td colspan="8" align="left"><input name="Grade812" size="85"></td>
</tr>
<tr align="left">
<td colspan="8" align="left"><input name="Grade813" size="85"></td>
</tr>
<tr align="left">
<td colspan="8" align="left"><input name="Grade814" size="85"></td>
</tr>
<tr align="left">
<td colspan="8" align="left"><input name="Grade815" size="85"></td>
</tr>



<tr align="left">
<td colspan="8">&nbsp;  </td>
</tr>

<tr align="left">
<td colspan="8">Enter the name of the <font color="#FF0308">alternate</font> for your Grade 8 Team #1:</td>
</tr>

<tr align="left">
<td colspan="8" align="left"><input name="Grade81a" size="85"></td>
</tr>

<tr align="center">
<td colspan="8"><hr width=90% height=5></td>
</tr>

<tr align="center">
<td colspan="8"><b>Grade 8 Team #2</b></td>
</tr>

<tr align="left">
<td colspan="8">Enter the names of the individuals comprising your Grade 8 Team #2:</td>
</tr>

<tr align="left">
<td colspan="8" align="left"><input name="Grade821" size="85"></td>
</tr>
<tr align="left">
<td colspan="8" align="left"><input name="Grade822" size="85"></td>
</tr>
<tr align="left">
<td colspan="8" align="left"><input name="Grade823" size="85"></td>
</tr>
<tr align="left">
<td colspan="8" align="left"><input name="Grade824" size="85"></td>
</tr>
<tr align="left">
<td colspan="8" align="left"><input name="Grade825" size="85"></td>
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<tr align="left">
<td colspan="8">&nbsp;  </td>
</tr>

<tr align="left">
<td colspan="8">Enter the name of the <font color="#FF0308">alternate</font> for your Grade 8 Team #2:</td>
</tr>

<tr align="left">
<td colspan="8" align="left"><input name="Grade82a" size="85"></td>
</tr>

<tr align="center">
<td colspan="8"><hr width=90% height=5></td>
</tr>

<tr align="center">
<td colspan="8"><b>Grade 9 Team # 1</b></td>
</tr>

<tr align="left">
<td colspan="8">Enter the names of the individuals comprising your Grade 9 Team #1:</td>
</tr>

<tr align="left">
<td colspan="8" align="left"><input name="Grade911" size="85"></td>
</tr>
<tr align="left">
<td colspan="8" align="left"><input name="Grade912" size="85"></td>
</tr>
<tr align="left">
<td colspan="8" align="left"><input name="Grade913" size="85"></td>
</tr>
<tr align="left">
<td colspan="8" align="left"><input name="Grade914" size="85"></td>
</tr>

<tr align="left">
<td colspan="8">&nbsp;  </td>
</tr>

<tr align="left">
<td colspan="8">Enter the name of the <font color="#FF0308">alternate</font> for your Grade 9 Team #1:</td>
</tr>

<tr align="left">
<td colspan="8" align="left"><input name="Grade91a" size="85"></td>
</tr>

<tr align="center">
<td colspan="8"><hr width=90% height=5></td>
</tr>

<tr align="center">
<td colspan="8"><b>Grade 9 Team #2</b></td>
</tr>

<tr align="left">
<td colspan="8">Enter the names of the individuals comprising your Grade 9 Team #2:</td>
</tr>

<tr align="left">
<td colspan="8" align="left"><input name="Grade921" size="85"></td>
</tr>
<tr align="left">
<td colspan="8" align="left"><input name="Grade922" size="85"></td>
</tr>
<tr align="left">
<td colspan="8" align="left"><input name="Grade923" size="85"></td>
</tr>
<tr align="left">
<td colspan="8" align="left"><input name="Grade924" size="85"></td>
</tr>

<tr align="left">
<td colspan="8">&nbsp;  </td>
</tr>

<tr align="left">
<td colspan="8">Enter the name of the <font color="#FF0308">alternate</font> for your Grade 9 Team #2:</td>
</tr>

<tr align="left">
<td colspan="8" align="left"><input name="Grade92a" size="85"></td>
</tr>

<tr align="center">
<td colspan="8">&nbsp;  </td>
</tr>

<tr align="center">
<td>&nbsp;  </td>
<td>&nbsp;  </td>
<td align="right"><input type="submit" value="Submit"></td>
<td align="left"><input type="reset" value="Reset"></td>
<td colspan="4">&nbsp;  </td>
</tr>

<tr align="center">
<td colspan="8">&nbsp;  </td>
</tr>

<tr align="center">
<td colspan="8">You may also print and fax this form to The Registrar at 604-261-7748</td>
</tr>

<tr align="center">
<td colspan="8">&nbsp;  </td>
</tr>

<tr align="center">
<td colspan="8"><a href="../index.html" target="_blank">Return to the Main Page</a></td>
</tr>

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</form>

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