11th IMSPQ Registration Form

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11TH IMSPQ 2013 REGISTRATION FORM Please complete the form below to register your participation to the 11th

IMSPQ 2013. Dateline for submission: 30th April 2013

1. Full name of the university / college that you are representing: 2. Your university / colleges logo (please attach if possible):

3. Team photo: (Can be sent later) Please attach your team photo (including the accompanying lecturer) here (Please match the names with the people in the photo). 4. The total number of delegates (both students and accompanying lecturer / staff) joining the quiz: Students: Lecturer/ staff:

5. Please list the name of the accompanying lecturer/ staff:

6. Please list the full name of the students: Male student

Female student

(Please indicate the students who require hostel stay by *) 7. Please indicate the number of vegetarian diet required by your delegate members:

8. Do you require any formal invitation letter for VISA application? *Yes/ No (If yes, please provide the full postal address to where the letter should be sent)

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