Residence Accommodation

FINAL APPLICATION FORM

for RESIDENCE ACCOMMODATION in

FREDERICTON

for the

NEW BRUNSWICK MATHEMATICS COMPETITION

PLEASE RETURN THIS FORM NO LATER THAN Friday, April 1, 2011

DO NOT PRESS the "Enter" key.

NAME OF SCHOOL
SCHOOL DISTRICT #
EMAIL ADDRESS

RESIDENCE REQUIREMENTS:

SINGLE ROOMS @ $20.50 + HST; DOUBLE ROOMS @ $35.00 + HST

Please list the names of the chaperones and students and indicate their gender.

CHAPERONES
1. male female
2. male female
3. male female
4. male female
5. male female
STUDENTS
1. male female
2. male female
3. male female
4. male female
5. male female
6. male female
7. male female
8. male female
9. male female
10. male female
11. male female
12. male female
13. male female
14. male female
15. male female
16. male female
17. male female
18. male female
19. male female
20. male female
21. male female
22. male female
23. male female
24. male female

ARRIVING: DAY TIME
DEPARTING: DAY TIME

	CHAPERONES
1.		male	female
2.		male	female
3.		male	female
4.		male	female
5.		male	female
	STUDENTS
1.		male	female
2.		male	female
3.		male	female
4.		male	female
5.		male	female
6.		male	female
7.		male	female
8.		male	female
9.		male	female
10.		male	female
11.		male	female
12.		male	female
13.		male	female
14.		male	female
15.		male	female
16.		male	female
17.		male	female
18.		male	female
19.		male	female
20.		male	female
21.		male	female
22.		male	female
23.		male	female
24.		male	female

A cheque/money order for the full amount to cover the cost of lodging should be made out to UNB and mailed to:

Attention: Misty McLaughlin
Residential Life and Conference Services
University of New Brunswick
P.O. Box 4400
Fredericton, N.B.
E3B 5A3

NOTE: PAYMENT FOR ROOMS MUST BE MADE AT LEAST ONE WEEK IN ADVANCE.

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