SHS Student Simulation Competition Entry Form

 *Team name:                                   

 * School:                                           

 *Faculty advisor's name (Prefix, First Name, Last Name) :                

  Mr. Ms. Mrs.    

 Membership number:                

*Faculty advisor's phone:              

*Faculty advisor's email:               

*Faculty advisor's address:            

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*Team leader (Prefix, First Name, Last Name):                             

  Mr. Ms. Mrs.  

*Team leader address :                   

*Team leader phone:                   

*Team leader email:                   

Membership number:                      

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*Team member's name (Prefix, First Name, Last Name):              

Mr. Ms. Mrs.    

*Team member address :                

*Phone:                                      

*Email:                                       

Membership number:                      

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Team member's name (Prefix, First Name, Last Name):            

  Mr. Ms. Mrs.     

Team member address :               

Phone:                                        

Email:                                       

Membership number:                  

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Team member's name (Prefix, First Name, Last Name):            

Mr. Ms. Mrs.     

Team member address :               

Phone:                                    

Email:                                      

Membership number:                 


*denotes required field

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Payment Information 

Select payment type 

1. Visa
2. MasterCard
3. American Express
4. Check

                      

If paying by check, mail a copy of this form to:

IISE
3577 Parkway Lane, Suite 200
Norcross, GA 30092
Attention: Brian Charles

Card number:                      

Expiration date: