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| First Name: | |
| Last Name: | |
| School: | |
| School grade entering this Fall: | |
| LAMC Group you wish to attend: | |
| Birth Year | |
| Did you attend LAMC before? | |
| For statistical and funding purposes, we would like to collect demographic information on our participants. | |
| Are you male or female? | |
| What is your ethnic background? | |
| Please list math classes you have taken last year. This information is helpful in planning our sessions. | |
| Check this box if you would be interested in taking the AMC-8 exam at UCLA. You will be asked to register later in the year. | |
| Check this box if you would be interested in taking the AMC-10 or AMC-12 exam at UCLA. You will be asked to register later in the year. | |
| Login (use your e-mail address, must be unique) | |
| Password | |
| Retype password | |
| Contact e-mail | |
| Contact parent first name | |
| Contact parent last name | |
| Parent e-mail | |
| Home address: | |
| Contact phone | |
| Check this box if your family would like to volunteer in LAMC (for example, bring snacks, help organize parent meetings, help with exam and Olympiad registrations, etc.) You will be contacted separately later in the year. | |
| Check this box if your family would like more information about donating to LAMC. LAMC meetings are free of charge. LAMC seeks donations to cover its operation costs, such as LAMC assistants stipends, exam registrations, photocopying, student prizes, etc. | |
| How did you hear about us? | |
| Occasionally, we take pictures at LAMC meetings, which may be used for publicity purposes [e.g.: posted on our web site or used in a brochure about LAMC.] Do you give us permission to include you in such photographs? Please type 'Yes' if you agree. | |
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