Sliffe Awards

2009 AMC 8/Middle School Sliffe Awards Teacher Response Form

This form is to be used to respond to the email sent you, which requested information needed for processing the 2009 AMC 8 Edyth May Sliffe Awards.
We will also need a picture, any size or shape.
- Please attach it to an email, and send it to: amcinfo@maa.org with the subject line: 2009 AMC 8 Sliffe photo
- or you can mail it to the address below.
This is not a secure site. If you feel uncomfortable submitting your social security number over the web (it is required by the government to issue the check), please feel free to call 800/527-3690 between the hours of 8 am-3:40 pm, M-F, and ask for Rachelle Jensen, or you can mail it to:

Rachelle Jensen
AMC 8 - Sliffe Information
University of Nebraska - Lincoln
1740 Vine Street
Lincoln, NE 68516

Thank you!

Title:

First name:

Middle Name

Last Name:

School

School Address

City

State

Zip

General School Phone

Teacher's School Phone

Teacher's School Email

School Web Address

School Type

Public
Private
Home School

PRINCIPAL:

Title:

First name:

Middle name or intitial:

Last name:

Principal or Headmaster's Email:

Teachers Home Address

City

State

Zip

Social Security Number
(needed for the check)

Home Phone

Home Email

I will be submitting the photo: