Team Information Form

Iowa Regional Future City Competition

Much of the information requested here has already been obtained through each school's registration; however, for confirmation purposes and because things change, please fill out this form below on or before November 15, 2005.  If you have more than 4 teams and will need to have an in-school competition, then you will need to identify which teams will represent your school no later than January 9, 2006.

-- Teacher Info --

School:

Location:

Teacher:

Best way to be reached (Fill in all fields and select one option):

Phone (i.e., 555-555-1212):

Fax (i.e., 555-555-1234):

Email:

Best time(s) to be reached (Hold the CTRL key to select more than one time):

If "Other" please specify:

Can you received attachments in your email?          Yes  No

-- Engineer Mentor Info --

Number of Mentors:

Mentor:     

Company/Firm:   

Best way to be reached (Fill in all fields and select one option):

Phone (i.e., 555-555-1212):

Fax (i.e., 555-555-1234):

Email:

Best time(s) to be reached (Hold the CTRL key to select more than one time):

    If "Other" please specify:

Can you received attachments in your email?          Yes  No

-- Team Info --

Number of teams:   Only 4 teams will be able to compete at the Regional Competition on January 28, 2006.  If you have 5 or more teams you will need to have a school competition or choose the 4 teams by January 9, 2006.  If you have selected "5 or More", and have selected school competition below, please enter the date of your school competition.

    School Competition?          Yes  No                 

    Date of School Competition (mm-dd-yy):

 

Team1:     Team2:

                         

                          

Team 3:    Team 4:

                          

                          

Team 5:    Team 6:

                          

                          

Team 7:    Team 8:

                          

                          

Team 9: Team 10: