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16th Annual CCSC:Southeastern Conference @ Georgia Perimeter College
Conference Date: November 7-8, 2003
Location: 2101 Womack Rd., Dunwoody, GA 30338

Southeastern Small College Programming Contest REGISTRATION FORM

Notes:

• This form must be used to register a team.
• The registration deadline is midnight on October 25, 2003.
• Please submit a separate form for each team you wish to register. Identify the different teams as #1 and #2.
• The team sponsor must be registered for the CCSC:Southeastern Conference. (Students may also register at a reduced rate, but it is not required.)
• Your registration will be complete upon receipt of this form and receipt of the registration fee by Dr. Dee Medley, CCSC:SE Treasurer. The fee is $20 per team, plus $10 per individual team member. (Details here.)
• Before submitting this form, please be sure to read all additional contest information thoroughly.
• Your electronic registration will be confirmed by return e-mail. If you do not receive this confirmation, please contact Lorie Moffitt to make sure that you are registered.

School Name:

Team Number:

1

2

Language selection (check one):	C/C++	Java
	Ada	Visual Basic

Each team must have a minimum of two members and a maximum of four.

Team Member #1:
Team Member #2:
Team Member #3:
Team Member #4:

A faculty sponsor must accompany the team(s) from each school.

Faculty Sponsor:
Work Address:
City, State, Zip:
Telephone:
E-mail:

I certify that the above named students are currently enrolled in this school, and are thereby eligible to participate.

Name:
Date: