Application Form for Regional Mathematical Olympiad 2011

(To be Iilled in by the School/College OIIice)

Name oI the School/College:


Postal Address oI the School:


Telephone Numbers oI the School/College:


Name, Address and Cell No. oI the Teacher in Charge:


Total Number oI Students Appearing Irom your School/College:

Medium in which the students want to write RMO examination:
(English/Marathi/Hindi)


Details oI the Demand DraIt drawn:

Drawn in the Name oI: Regional Coordinator (RMO & INMO) Maharashtra

Drawn on bank:

Demand DraIt number:

Date on which drawn:

Amount payable by the D.D.:
(Rs. 100 L Number oI students)


Stamp oI College /School:





Date:
Signature oI Principal











Details oI the students appearing

No. Name oI the Student Std. in
which
studying
Home Address with telephone
number/numbers
Email address