Southwest Georgia Regional Model Bridge Building Competition

 

Registration Form

 

 

School Name: _______________________________________

 

Teacher: _______________________________ Size of T-Shirt Preferred: _______

 

Team Members:

 

Name                                                              Grade Level                 Size of T-Shirt Preferred

 

1. _____________________________            ______                  ___________

 

2. _____________________________            ______                  ___________

 

3. _____________________________            ______                  ___________

 

 

School Address:

Street Address:   _____________________________

City:                       _____________________________

Zip Code:              _____________________________

 

Teacher's Phone No.:        ______________________

Teacher's e-mail Address: ______________________

  

 

Please mail the above form along with a check for $15 registration fee drawn in favor of Georgia Space Grant Consortium to:

 

Ashok Jain Ph.D.

Professor of Biology

Albany State University

504 College Dr

Albany, GA 31705

 

Phone: 229-352-1562

e-mail: atin.sinha@asurams.edu

 

 Teams are limited to three students. A separate registration form and fee are required for each bridge entered in the competition.

 

Deadline for Registration:    January 31, 2017