REGISTRATION FORM

2017 PRIME Baja SAE□ KOREA at Yeungnam University

12 July - 15 July 2017, Yeungnam University, KOREA

Please complete and return this form for each team entry as soon as possible. Please ensure you submit your registration form before Friday, JUN 16 2017.

Team Information

Name of University or College:

Name of car :

Name of group:

Number of team members:          persons (Faculties:         Students:          )

Faculty Advisor Information

Name of advisor:

Department:

Postal address:

Telephone Number:

Fax Number:

Cell phone number:

E-mail address:

Team Captain Information

Name of advisor:

Department:

Postal address:

Telephone Number:

Fax Number:

Cell phone number:

E-mail address:

Roster

Name	Residents registration number (Korean students) Passport Number (International students)	Department	Contact telephone number	Responsibility

Our team makes the pledge that all the contents in this form have true. We promise to be familiar with the safety guidelines set out by the host and cooperate by conducting sincerely in the contest.

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Team Captain

(signature)                                    (date)

Faculty Advisor

(signature)                                    (date)