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									Registration for the 5th Mental Calculation World Cup
Gießen, Germany, 29 September – 1 October 2012

www.recordholders.org/en/events/worldcup/

Please send this form to: Ralf Laue, Bamberger Str. 53 a, 04207 Leipzig, Germany
Deadline: 1 June 2012
The number of participants is limited to 40. If more people register for the event, the organizer reserves
the right to select the participants who qualify.


Hereby I register in order to participate in the Mental Calculation World Cup 2012

First name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Family Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Occupation: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Complete postal address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Nationality: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
E-mail: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Date of birth: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .


Results at mental calculation competitions in the past: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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Results with the MEMORIAD training program, available at
www.recordholders.org/downloads/worldcup/Memoriad_Setup.exe
(These results MUST be achieved in front of official witnesses like maths teachers, mathematicians at a
university, or people in a comparable position. Please include their confirmation letters!)
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I speak: □ German / □ English / □ French / □ Russian / □ Spanish
□ other languages: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

I will participate in the following categories:
□ main competition (addition, multiplication, extracting square roots, calendar from memory, surprises)
□ Just the following categories:
  □ Addition       □ Multiplication      □ Square Roots □ Calendar


I need accommodation in Gießen
 from 29-30 Sept                  from 30 Sept-1 Oct                                                        from 1-2 Oct
for me and ... accompanying persons.


Date, Signature:


Note: We do not send back a written confirmation of receipt. Your e-mail address will be used for all
correspondence!

								
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