The Western Kentucky Physics Olympics:  Online Registration Form

Please complete the online registration form below.  Required fields are indicated with an asterisk.  If you have any problems using this online form please contact Dr. Richard Gelderman at 270-745-6203.

There is no registration fee for participation in the Western Kentucky Physics Olympics.  However, to complete the registration process we require a current photo of the coach and each team member be submitted. Photos can be electronic (either jpg or gif file) images e-mailed to olympics@physics.wku.edu or hardcopies snail-mailed to:

Physics Olympics
c/o Dr. Richard Gelderman
Department of Physics and Astronomy
Western Kentucky University
1906 College Heights Blvd. MS 11077
Bowling Green, KY 42101-1077

Please complete the following ...


School Information

School Name: *  
Coach's Name: *  
Address: School address will be used to mail contest materials to team.
  *
 
City                     State    Zip Code
Local Newspaper
Coach's eMail: * Newspaper:  

Coach's eMail will be used to send Registration Confirmation

Coach's Phone: Address:  
Principal's Name:  

Team Name: *  

Team CAPTAIN

Team Member 2

Name: * Name: *
Address: * Address: *  
   *
 
City                     State     Zip Code
*
 
City                     State    Zip Code
e Mail: * eMail: *
Phone:   Class:  * Phone:   Class:  *

Team Member 3

Team Member 4

Name: * Name: *
Address: *   Address: *  
  *
 
City                State   Zip Code
  *
 
City                     State   Zip Code
eMail: * eMail: *
Phone:   Class:  * Phone:   Class:  *

 



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