Junior National Academic Championship

Registration form

School Name:_____________________________________________________

Address:__________________________________________________________

City, State, ZIP_____________________________________________________

Telephone_________________________________________________________

Principal's Name____________________________________________________

Coach's Name______________________________________________________

Home address______________________________________________________

City, State, ZIP_____________________________________________________

Home phone_______________________________________________________

Cell phone_______________________________________________________

Email address______________________________________________________

Note: Don't leave this blank.



Choice of Location: O New Orleans, May 29 - 31

O Washington, D.C., June 5 - 7

O Chicago , June 12-14

Please list all persons coming to the Junior National Academic Championship and indicate whether they are Adult/Male, Adult/Female,Student/Male, or Student/Female. Entry Only Entry & Room Entry, Rooms & Meals
(Please see fee schedule)
1. Captain: O O O
2. O O O
3. O O O
4. O O O
5. O O O
6. O O O
7. O O O
8. O O O
9. O O O
10. O O O
11. O O O
12. O O O
13. O O O
14. O O O

Total Entry Fee Enclosed: _____________________

Estimated time of arrival at competition site :_____________
Note: Don't leave this space blank. Let us know by May 15 if this ETA will change.

For your convenience and enjoyment while you're at Nationals, you are welcome to cross-out one time frame, below, during which you DO NOT WANT YOUR GAMES SCHEDULED, for the purpose of sightseeing or for any other reason. You needn't cross-out any time slots if you have no preference.

First competition day, morning
First competition day, afternoon
First competition day, evening
Second competition day, morning
Second competition day, afternoon
Second competition day, evening

Make check(s) to National Academic Championship and mail to:
National Academic Association
1540 Siesta Dr.
Sandy, UT 84093