| Number of packets (1 per team) ______ |
| Name________________________________________ |
| Address________________________________________ |
| City/Zip ______________________________________ |
| Phone (home)____________________________________ |
| Phone (work)____________________________________ |
| E-mail__________________________________________ |
| Possible Team Name ______________________________ |
| Expected Level __________________________________ |
|
Wanda Hsiung - Registrar
6504 Westmoreland Ave.
Takoma Park, MD 20912-4752
wanda.hsiung@chrva.org
|