Registration Form

After completing the Junior Diagnostic Quiz with your 5^th or 6^th grade class, enter the Junior Diagnostic contest by filling out the following fields, and become eligible to win a laptop computer. Thank you and good luck!

Region*

Your school*

Address*

City*

Postal Code*

Telephone*

Principal's name*

Teacher's name*

Grade*

Class number*

Number of students*

How would you say your students enjoyed the activity: very much, somewhat, not very much, or not at all?

As the organizer of this activity, would you say that you had sufficient information and materials to carry out this project in class?

YesNo

We would appreciate any comments that might help us improve this activity:

*Required fields

I declare having read and understood the contest rules and abide by them.

Click here to learn about the participation period of your region.