REGISTRATION FORM IKMC2015

INSTRUCTIONS & IMPORTANT DEADLINES.

  1. Please fill all the columns with Black/Blue permanent ink in Capital letters only.
  1. A separate registration page(Page 05 of registration form) may be used for each participating class. (Don’t register the Names of students from multiple classes on one page).
  1. Minimum Participation of 10 students from a participating class is MUST.There is no maximum limit; institutions can registeras many students from a class as they wish.
  1. The last date of submitting registration form is December31, 2014with normal fee,after this date the institutions can register by paying late fee ofRs.5,000(per institution) till January 7,2015and by paying double late fee of Rs. 10,000(per institution) till January15, 2015. Thereafter no registration will be accepted.
  1. The Contest will be held on March 19, 2015. (10:00 AM.)
  1. The participation fee is Rs.600 per participant, which can be paid only through Bank Draft/Pay Order,drawn in favour of KSF-Pakistan. The registration will not be accepted if the fee is sent in any other form
  1. The registration fee once paid is non-refundable and non-transferable.
  1. The registration forms complete in all respect should be sent to the following Postal Address:

KANGOUROU SANS FRONTIERES - PAKISTAN

International Kangaroo Mathematics Contest

2ndFloor, 302 –Y / Commercial Area, Phase – III,

Defence Housing Authority,

Lahore Cantt. 54660

  1. All particulars in the registration form must be filled as illustrated below. Variation from the format can result into the rejection of registration.

S.NO / STUDENT’S PARTICULARS
STUDENT’S / First Name / H / A / S / S / A / N
Middle Name / B / I / N
Last Name / W / A / L / E / E / D
FATHER’S / First Name / W / A / L / E / E / D
Middle Name / A / H / M / E / D
Last Name / M / A / S / H / W / A / N / I

For any further assistance, you can contact KSF–PAKISTANoffice by e-mail at , phone: +92-42-35744666 and cell: +92-324-4219999.

  1. INSTITUTION’S DETAILS

INSTITUTION’S NAME:

INSTITUTION’S POSTAL ADDRESS:

HOUSE NO
STREET NO
OTHER DETAILS
CITY
TEHSIL
DISTRICT
PHONE : 01
PHONE : 02
FAX
E-MAIL

OFFICIAL BANK TITLE OF THE INSTITUTION’S ACCOUNT:

  1. PRINCIPAL’S CONTACT DETAIL (FIRST CONTACT POINT)

*All columns are mandatory.

FIRST NAME
MIDDLE NAME
LAST NAME
CELL PHONE
OFFICE PHONE
E-MAIL
  1. COORDINATOR’S CONTACT DETAIL (SECOND CONTACT POINT)

Institution must nominate anofficial to coordinateandto correspondin the absence of principal.

FIRST NAME
MIDDLE NAME
LAST NAME
CELL PHONE
OFFICE PHONE
E-MAIL
  1. COURIER & MAIL OPTIONS:

The Examination material & other correspondence will be sent out to participating institutionby using the mailing optionschosen bythem. Please indicate your choice by ticking the appropriate box. Please re-assure from the service providers (TCS/PAKISTAN POSTAL SERVICES) that your institution is located in a serviceable area of service provider.

1. Courier Service TCS.

2. Pakistan Postal services (Registered or UMS mails).

  1. DETAIL OF REGISTRED STUDENTS.

Class-wise summary of students to be registered:

LEVEL / CLASS / NO. OF STUDENTS
(in figures)
PRE-ECOLIER / 01 / ONE
02 / TWO
ECOLIER / 03 / THREE
04 / FOUR
BENJAMIN / 05 / FIVE
06 / SIX
CADET / 07 / SEVEN
08 / EIGHT/O LEVEL-I
JUNIOR / 09 / NINE/O LEVEL-I & II
10 / TEN/O LEVEL-II & III
STUDENT / 11 / ELEVEN/O LEVEL III & A LEVEL-I
12 / TWELVE/A LEVEL-I & II
TOTAL NO OF STUDENTS
  1. UNDERTAKING.

I hereby certify that:

  1. I undertake the full responsibility to act as aChief Examiner for the written test of IKMCand to conduct the exam following the IKMC code of conduct and by making all necessary examination arrangements at our institution maintaining the international standards and ensuring the secrecy & transparency of the written test.
  2. I also assure thatmy institution will fully abide by IKMC code of conduct, all rules, regulations and instructions of the International Kangaroo Mathematics Contest being enforced time to time.
  1. Ialso certify that I have enclosed Bank Draft/Pay Order in original bearing No: ______Dated: ______amounting to Rs.(in figures)______as a registration fee for total number of ______students as mentioned in above summary @ Rs.600 per student in favour of KSF-PAKISTAN.

SIGNATURES & STAMP

PRINCIPAL /HEAD OF THE INSTITUTION

STUDENTS REGISTERATION SHEET

FOR THE CLASS______

A separate registration page may be used for each participating class. Don’t register the Names of students from multiple classes on one page. Please fill the particulars of students very carefully according to your institution’s office record using capital letters. These particulars will appear on the certificates/mark sheets. Any change requested therein after the issuance of result/certificates will be subject to the payment of a fee of Rs. 1,000 per document.

S.NO / STUDENT’S PARTICULARS
STUDENT’S / First Name
Middle Name
Last Name
FATHER’S / First Name
Middle Name
Last Name
STUDENT’S / First Name
Middle Name
Last Name
FATHER’S / First Name
Middle Name
Last Name
STUDENT’S / First Name
Middle Name
Last Name
FATHER’S / First Name
Middle Name
Last Name
STUDENT’S / First Name
Middle Name
Last Name
FATHER’S / First Name
Middle Name
Last Name
STUDENT’S / First Name
Middle Name
Last Name
FATHER’S / First Name
Middle Name
Last Name
STUDENT’S / First Name
Middle Name
Last Name
FATHER’S / First Name
Middle Name
Last Name

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