1. acm International Collegiate Programming Contest
Asia Regional Contest-2007, KANPUR SITE
Team Registration Form
Note: WRITE NAME OF THE CONTESTANTS AND COACH EXACTLY AS THEY SHOULD
APPEAR ON THE CERTIFICATES etc.
Team Name-
• Demand Draft Details- (Please write your team name at the back side of each draft)
Demand Draft 1 Demand Draft 2
Bank Name: Bank Name:
Demand Draft Number: Demand Draft Number:
Amount: Amount:
Rs. 1000/=
1500/= Rs. 1000/=
Dated: Dated:
/ /2007 / /2007
• University / College Information-
Institution Name
Short Name e.g. IITK
Home Page http://
Does the Institution have a graduate program in a computing discipline? Yes/No
• Correspondence Address for the Team:
Pin
Coach Information-
Coach’s Name
Job Title
Gender M/F T-shirt Size: S/M/L/XL/XXL
Phone Number (O) (R)
Mobile Number (if any) Fax Number (if any)
E-Mail Address: @
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2. Contestants Information-
Contestant 1 Contestant 2 Contestant 3
Contestant Name
- - - - -
-
Date of Birth (dd-mm-yy)
Gender (M/F)
Phone Number
E-mail Address
Degree Pursuing
Date of Joining
Graduation Date
T-shirt Size(S/M/L/XL/XXL)
Declaration by Director/ Head/ Principal of the Institute-
I, , certify that the contestants listed above satisfy the eligibility
criteria of ACM International Collegiate Programming Contest of 2007.
Date: Signature with Stamp
Send this duly filled registration form with TWO demand drafts (one of Rs. 1500/- and one of Rs.
1000/-) drawn in favor of “ACM Kanpur” (Payable at Kanpur) along with one self addressed
envelope to the following address. Ensure that registration materials reach to us on or before 14th
September, 2007.
Prof. Phalguni Gupta,
Regional Contest Director Kanpur Site,
Department of Computer Science & Engineering,
Indian Institute of Technology Kanpur, Phone No: +91-512-259-7252,
Kanpur (U.P.), 208 016, Fax No.: +91-512-259-0413,
INDIA. E-Mail: acm@cse.iitk.ac.in
For more details please visit our web site: http://www.cse.iitk.ac.in/users/acm
Note:
1. In case a team does not qualify in the preliminary contest, the draft of Rs. 1000/- will be returned at
the correspondence address as filled (at page 1) in this form.
2. Please write the same correspondence address as filled in Page 1 in self addressed envelope.
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