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N A L I N I F O U N D A T I O N F O R S Y M B O L I C L O G I C Saavitri Apartments, Nirmal Baag, Pune 411009, India Tel. 91-020-4226530; Telefax: +91-020-4220248 email: nugar@vsnl.com; Website http://www.iccs.8m.com/ Form of registration for contestants from INDIA only International Computing Contest ICC-2001 to be held on Sunday, January 21, 2001 Last date for receipt of completed site registration form: December 15, 2000. Contestant to fill in the application, circling applicable items. ( A Xerox copy of this form is acceptable) 1. Last name: First name: Sex(M/F) 2. Level at which contesting: ( ) Elementary ( ) Junior ( ) Senior 3. Language in which contesting (Check only one) ( ) BASIC ( ) PASCAL ( ) C ( ) C++ ( ) Logo ( ) Other (specify) 4. Residential Address: House/Apt number & Name : Name of Road/street or other landmark : City, Zip code and Country : Residential Telephone number (with STD code) : email address : 5. Name of teacher/adviser/mentor for contest : Tel. No. of the adviser: Residence: :Office Having read the rules of the contest, I undertake to abide by them. Dated: ( Signature of contestant) 6. Certfication by the Institute: Certified that institue will provide computer facilities to the abovenamed contestant and supervise the contest on behalf of Nalini Foundation. Name of the Institution to Seal and Signature of the which the contestant is affiliated Office bearer. Full address of the institution: Contest Supervisor's Name: Contact Tel. No. (instt) : (Resi) : - - - * - - -
This page has been visitedtimes since 15th August 2000.