Applications for MARY/EMPT 


Name of School: ________________________________________


Contact person in school: _______________________________


School address: _________________________________________

                _________________________________________


Contact person e-mail: __________________________________


County (or Baltimore City): _____________________________


Public or Private: ______________________________________


Approximate number of answer sheets required: ___________

   (The test is intended mostly for high school juniors, 
    but some schools also use it for other students. 
    We will be happy to process all tests.) 

Approximate number of tests required: ___________________ 

   (You can conserve by scheduling so as to use tests more than once.) 


Two-week interval we would like to schedule tests: ___________________

   Priority in scheduling is given to requests received first. 
   We reuse test booklets to save money. Please schedule the 
   test so that you can return materials with three weeks of receipt.) 

Second (***LATER!!***) choice of two-week interval: _________________________

   Mailing and processing take time. Expect your results and materials 
   to reach you about three weeks after you send us the completed
   tests.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

You can return the completed form to the director of 
MARY/EMPT (Dr. Justin Wyss-Gallifent) in any of three ways: 

SURFACE MAIL:   MARY/EMPT 
	        Department of Mathematics 
	        University of Maryland 
		College Park MD 20742-4015 
    
E-MAIL:		jow@math.umd.edu 
		
		
FAX:		301-314-0827 

<!-- Localized -->