College or University: __________________________________

Number of teams competing from your university: _______

The faculty advisor must be willing to serve as a contact point for the team(s) and certify the eligibility of the team members. Faculty advisorx do not have to be present at the contest, though they are certainly welcome.

Facutly Advisor:

Name: ___________________________________________________

Address: _______________________________________________________

________________________________________________________________

City: ___________________________ State: ______ Zip: ______________

Phone: ___________________________ Email: _____________________________

Fax: _______________________________

I certify that our contestants will satisfy the eligibility requirements of the Contest Rules.

Advisor Signature: _______________________________________

Indicated the site which you would prefer to attend. Please list a first and second choice. Every effort will be made to honor your preference subject to the priorities in the Call For Participation.

             _____  Bucknell University

             _____  University of Delaware

             _____  Duke University

             _____  Lehigh University

             _____  Virginia Tech
 
             _____  William & Mary

A fee of $75 per team will be used to cover expenses. Lunch, snacks, and a wrap-up pizza party will be provided for contestants, alternates, coaches, and contest staff. Teams which are denied a seat in the contest because of space limitations or withdraw two (2) days prior to the contest will receive a refund of this fee.

Please fill in this form and return it to the address below as soon as possible. It must be received by Friday, November 8, 1996 and must be accompanied by a check for $75 per team payable to the Villanova University ACM. It is imperative that you meet the registration deadline to ensure proper coordination between sites.

Send the registration form and fee to:

          ACM Mid-Atlantic Regional Contest
          c/o John Lewis
          Department of Computing Sciences
          Villanova University
          Villanova, Pennsylvania 19085-1699