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SHS Student Simulation Competition Entry Form

 *Team name:                                   

 * School:                                           

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

    

 Membership number:                

*Faculty advisor's phone:              

*Faculty advisor's email:               

*Faculty advisor's address:            



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

   

*Team leader address :                   

*Team leader phone:                   

*Team leader email:                   

Membership number:                      



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

   

*Team member address :                

*Phone:                                      

*Email:                                       

Membership number:                      



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

     

Team member address :               

Phone:                                        

Email:                                       

Membership number:                  



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

    

Team member address :               

Phone:                                    

Email:                                      

Membership number:                 


*denotes required field


Payment Information 

Select payment type 

                    

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

IISE
3577 Parkway Lane, Suite 200
Norcross, GA 30092
Attention: Bonnie Cameron

Card number:                      

Expiration date: