mathFACTOR 2012 Application Form

Please complete this form, which will not be seen by the judges before your audition.

Firstly, some information about you:
Name: _________________________________________________________________________
E-mail address: _________________________________________________________________
Contact telephone: _______________________________________________________________
School Name: ___________________________________________________________________
Country: ________________________________________________________________________
Secondly, some questions about mathFACTOR:
1.

Which subject did you chosen for your presentation and why? (max 100 words)

2.

Please outline the source of the material for your presentation (max 100 words)

EUROMATH 2012 Conference
21-25 March 2012, Sofia, Bulgaria

Finally, some more questions about you:
3.

Are you:
Male

4.

Female

Birthdate: _____________

Signed: ………………………………………………………… Date: ……………………………
Please send the completed by fax or e-mail to:
CYPRUS MATHEMATICAL SOCIETY
Fax: +357 22 379 122
E-mail: cms@cms.org.cy

Deadline for receipt of application forms: 31 January 2012
Thank you and good luck!

EUROMATH 2012 Conference
21-25 March 2012, Sofia, Bulgaria

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