AMC 10/12 - Mathematical Association of America
2015 AMC 10/12 Registration Form February 3, 2015 February 25, 2015 800.527.3690/phone | 240.396.5647/fax | [email protected] | maa.org/math-competitions Did you know you can register online and get a $10.00 discount? amc-reg.maa.org We accept checks, P.O.’s, VISA, MasterCard, American Express and Discover. All forms of payment are accepted online. Orders for the A date will start shipping January 2, 2015 and for the B date on February 3, 2015. Step 1: School Information Please keep in mind that this is a school-based competition; learning centers, parents or students cannot register. We reserve the right to decline registration. School Code : oooooo Promotion code: _____________ ______________________________________________________________________________________________ School: ________________________________________________________________________________________________________________ School street address: ______________________________________________________________________________________________________ City: __________________________________________________________________ State: __________ Zip: _____________________ Teacher/Contest Manager: Please note: We cannot ship to PO Boxes or residential addresses. Country: _____________________________________________________________________________________________ School phone #: ( _______ ) _________________________________________________________ Email for confirmation & results: _____________________________________________________________________________________________ r I give the AMC permission to contact me regarding future contests via email. r I give the AMC permission to give my email to Colleges & other educational institutions with AMC approved educational opportunities for me & my students. r I do not want my school to show up on the AMC website’s Zip Code Search. Type of school: r r College/University Elementary School r High School r r Home School r Middle School r r r Check (Make checks payable to: Mathematical Association of America) (For international schools, please make sure U.S. transactions are approved with your credit card company. Orders on declined credit cards will be held until payment in full is made.) P.O. #: __________________________________________________________________ VISA MasterCard American Express or Discover Home schools, please provide Proctor name and address. The Proctor cannot be related to any student and contest materials must not be shipped to the home school location. Home School Proctor: ___________________________________________________________________________________________________________________________________________________________________________________________________________ Proctor address: __________________________________________________________________________________________________________________________________________________________________________________________________________________ Please note: We cannot ship to PO Boxes or residential addresses. State: (circle one) #: ______________________________________________ Expiration Date (MM/YY): ______/_______ Security Code: ______________ Print name on card: _______________________________________________ Signature: _______________________________________________________ Cardholder’s email: _______________________________________________ K-12 Teacher Member Benefits Include: Math Circle __________________________________________________________________ Payment is accepted in U.S. FUNDS ONLY. Payments submitted without completed registration form cannot be processed and will be returned. For wire transfers, please call customer service at 800-527-3690 for complete instructions. Step 4: Your AMC Registration Now Includes a Year of K-12 Teacher Membership in the MAA! Step 2: Home School Information City: Step 3: Payment Options __________ Email: ______________________________________________________________________________________________________________________________________ Please complete both sides of the form. Zip: _____________________ • Math Messenger, AMC’s monthly newsletter, now with links to your member benefits! • Electronic subscription to Math Horizons magazine (4 issues/year). • Electronic subscription to MAA FOCUS magazine (6 issues/year). • Discounted registration for MAA’s Annual Meetings--MAA MathFest and the Joint Mathematics Meetings. • Member discounts on MAA books, videos, and merchandise from the MAA Store. • Access to MAA’s Affinity Discounts Program. • Access to Curriculum Inspirations essays and companion videos. Curriculum Inspirations is an innovative and fresh resource for middle- and high-school mathematics educators on teaching the art of problem solving using the rich mathematical content of the MAA AMC contests. Competition problems are cross-referenced with Common Core State Standards in short, yet engaging, essays and problem solving strategies are demonstrated in lively companion videos. 2015 AMC 10/12 Registration Form February 3, 2015 February 25, 2015 800.527.3690/phone | 240.396.5647/fax | [email protected] | maa.org/math-competitions Step 6 Step 5 Pick Registration shipping by received-by date. Canada or International residents, please include additional shipping in Step 7. Fee covers 10/12 Registration, MAA K-12 Teacher Membership and Basic Shipping. You may register for one or both dates. The A contest and the B contest contain different questions but are of comparable difficulty. Declined or cancelled registrations include a $5 processing fee. Complete your registration online and get $10.00 off the registration price. Indicate your selection of contests and solutions. There are 10 contests per bundle and each bundle costs $20.00. Solution booklets will be sent with mailed school results. Solution orders include an electronic copy emailed after the contest period. To order Spanish or French contests, register online at amc-reg.maa. org. To order Braille or large print contests, email us at [email protected] at least 3 weeks before the contest date. Contests (10 contests per bundle) Registration & Shipping................................... $ 53.00 r Expedited Registration & Shipping............... $ 68.00 Contests Subtotal ($20/bundle) $ __________ $ __________ $ __________ $ __________ AMC 10 Solutions AMC 12 Solutions (Received Jan. 10–Jan. 23, 2015) Solutions Subtotal ($9/bundle) February 25, 2015 Contests & Solutions Subtotal Total for Step 6, Contests & Solutions .............................................................................$__________ r Expedited Registration & Shipping............... $ 78.00 Step 7 A Date Registration Subtotal............................... $_________ B Date Registration Subtotal................................ $_________ $ __________ Solutions (includes electronic copy after the contest period) (Received by Jan. 9, 2015) r Registration & Shipping................................... $ 63.00 $ __________ AMC 12 Contests r # of bundles AMC 10 Contests February 3, 2015 # of bundles (Received by January 23, 2015) (Received Jan. 24–Feb. 13, 2015) Total for Step 5, Registration............................$_________ Step 8 Add extra shipping if not in U.S. This is in addition to the Registration & Shipping in Step 5. Order 2 weeks before contest date to ensure delivery. Delivery charges must be paid for each contest date. Canada Add $10.00 $ __________ $ __________ Outside of the U.S. and Canada $7.00/bundle $ __________ $ __________ $ __________ $ __________ Order study materials to help your students prepare for the exam! Subtotal AMC 10/12 Math Club Package Add $25.00......................................................................... $ _______ Total for Step 7, Outside U.S. ...........................................................................................$__________ Math Wrangle Handbook Add $20.00......................................................................... $ _______ Shipping and Handling Order Amount USA Canada Overseas $10 to $50 $4.50 $10.00 $25.00 $51 to $100 $8.00 $12.50 $30.00 $101 to $150 $14.00 $20.00 $35.00 Step 9 Add sub-totals for steps 5, 6, 7 and 8. Order GRAND TOTAL................................................. $ _________ Must be paid in U.S. Funds. All orders are Non-Refundable once shipped. $ ________ Total for Step 8, Study Materials ...................... $________ Please complete both sides of the form. Fax or mail along with your payment or Purchase Order to: MAA American Mathematics Competitions ATTN: AMC 10/12 Registration P.O. Box 471 Annapolis Junction, MD 20701
© Copyright 2024