2005 AIME Teachers Manual -Form D, alternate AIME Payment Form

FORM D
2005 Alternate AIME Payment Form
Tuesday, March 22, 2005

The Alternate AIME on March 22, 2005 is a new set of 15 questions, completely different from, but comparable to the AIME on March 8, 2005. Please send payment before March 22, 2005.

PLEASE PRINT

School CEEB #: __ __ __ __ __ __

Contest Manager: ______________________________________________________

School Name: _________________________________________________________

School Address:_______________________________________________________

City: ___________________________ State: _________ Zip: ___________________

School Phone #: _______________________________________________________

E-mail: ______________________________________________________________

There will be a processing fee for the second AIME as follows: 1-10 students = $25, 11+ students = $50. We will need your payment before the answer forms can be graded. A special envelope and payment form has been included with your AIME material. All AIME answer forms must be returned by "express mail" so that they arrive in the AMC office by March 25, 2005.

Number of AIME qualifiers who will be taking the alternate AIME on Tuesday, March 22, 2005:

or	1-10 student qualifiers @ $25.00	$ __________
	11+ student qualifiers @ $50.00

Method of Payment:

	Check enclosed (US funds only) made payable and mailed with this form in the BUSINESS REPLY/postpaid envelope provided:
	AMERICAN MATHEMATICS COMPETITIONS University of Nebraska-Lincoln PO Box 880658 Lincoln, NE 68501-9988
	Charge to Visa/Mastercard #: ________________________________________
	Name on card (print): ______________________________________________ Signed: _________________________________________________________ Expiration Date: Telephone:__________________________________________

1-800-527-3690

E-mail: aimequal@amc.unl.edu

Fax: 402-472-6087