World Affairs Council Mid-Hudson Region, Inc.

Academic WorldQuest 2010

Team Members Registration

Sunday, December 6, 2009, 2:00 pm

at the

Henry A. Wallace Visitors and Education Center of the

Franklin D. Roosevelt Presidential Library, Hyde Park, NY

(Snow date: December 13th)

This form must be submitted to the World Affairs Council no later than November 30, 2009

School:
Coach/Advisor:	Email:

	STUDENTS' NAMES	GRADE	E-MAIL
	as they should appear on their certificates
Up to five students may be registered.

PLEASE NOTE: If you register 5 players, on the date of the competition one must be designated
as an alternate who can only be substituted in the event of an emergency.

	This space is for your comments and questions or to tell us of any special needs for your team.

You should print a copy of this page. You may print and return this form no later than November 30, 2009 to the World Affairs Council of the Mid-Hudson Valley, Inc. at:

c/o Joe Lombardi
469 Rossway Road
Pleasant Valley, NY 12569

If you haven't registered your TEAM yet, please click HERE

For additional information contact Joe Lombardi at the above address or by Email: AcWQ@hvworldaffairscouncil.org

Revised: 12/06/09