APPLICATION: NWMI MC3 Rich Math Tasks 2009

Since this is a stipended program, this program is not first-come, first served. After you submit your application, you will be contacted about acceptance. Print out this application, fill in all items, and send it to the address below. Better yet, GO TO THE STIPENDS PAGE AND SUBMIT YOUR APPLICATION ONLINE by filling out the Rich Math Tasks Stipend Request For,

Name _________________________________________

Home Address _________________________________

______________________________________________

Check whether you desire housing.


Rich Math Tasks July 27-31

Housing on campus?

Yes _____ No ______

School _____________________________________________

School Address _____________________________________

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Home phone (____) ______________ Work phone(____) _______________ Fax (____) ____________

Email ________________________________________

Signature ____________________________________

Mail to: NWMI
University of Washington
Department of Math, Box 354350
Seattle, WA 98195-4350 		Phone: (206) 543-1150
Fax: (206) 543-0397
Email: nwmi@math.washington.edu
Web page: http://www.math.washington.edu/~nwmi