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Qualification
Statement
University:
______________________________________________________________
Department/School:
______________________________________________________
Address:
_______________________________________________________________
City:
___________________________________ state: _____ zipcode:
____________
phone:
______________________ e-mail:____________________________________
Team Members
UG=Undergraduate Student;
G=Graduate Student
1.
Name:
_________________________________________________________________
ID:
________________________________ CPF:
_______________________________
Course:
_________________________________________________ UG:
____ G: ____
2. Name:
_________________________________________________________________
ID:
________________________________ CPF:
_______________________________
Course:
_________________________________________________ UG:
____ G: ____
3.
Name:
_________________________________________________________________
ID:
________________________________ CPF:
_______________________________
Course:
_________________________________________________ UG:
____ G: ____
Reserve.
Name:
_________________________________________________________________
ID:
________________________________ CPF:
_______________________________
Course:
_________________________________________________ UG:
____ G: ____
School
Advisor
Name:
_________________________________________________________________
ID:
_______________________________ CPF:
______________________________
Position:
________________________________________________________________
Coach (do not
fill if is the same as the school advisor)
Name:
__________________________________________________________________
ID:
_______________________________ CPF:
______________________________
I
guarantee that all information above is correct and that all cited
students attend the requirements for participating according to
the contest rules.
___________________________________
School
Advisor's Signature
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