2012 New York City Regional Brain Bee
Saturday, February 4, 2012

REGISTRATION FORM

The competition is open to students in grades 9–12 from the five boroughs of New York City and Westchester County. Participating schools may send up to two competitors. You must register your school using this form and submit the names of your competitors (via this form or by email to BrainBee@dana.org) by December 16, 2011.

*indicates a required field

*Name of high school:  
*Borough/County:


School contact


*Name:
   
Title:
   
Department:
   
School Address:
   
School City, State, Zip: 
 
Telephone: 
 
*E-mail:


Competitors


Student #1 name:         
Age:  

Grade:

  

Student #2 name:         
Age:  

Grade:

  

 

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