SRY Camp Nomination Form

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Teacher Information

Teacher - First Name

Teacher - Last Name

Teacher - Email Address

Position

School Name

School City

Student Information

Student - First Name

Student - Last Name

Student - Email Address

Parent/Guardian - First Name

Parent/Guardian - Last Name

Parent/Guardian - Email Address

Current Grade Level 9 10

Average Math Mark

Overall Grade Average

Is the student interested in learning mathematics that extends beyond their classroom? Yes No

Has the student competed in any Mathematics Competitions Yes No

If yes, which ones and what were the results?

Has the student attended a past SFU Math Camp? Yes No

If Student has attended a past camp, which location did they attend? Burnaby Camp Surrey Camp

I confirm my nomination of this student and confirm that the information entered above is all true to the best of my knowledge

Department of Mathematics