FTC™ Team Contact Entry Form Please enter your contact information below to express your involvement interests. Your interest will be forwarded to the registration committee for review. National Registration fee is $275.00 St. Louis Registration fee is $100.00 (Check grant eligibility requirement) Make check for $100 payable to St. Louis Community College Florissant Valley MAIL TO: Susie Mathieu 101 Austin Place St. Louis, MO 63122 Payment is due by October 31 2007 Registration is NOW OPEN Space is limited to 30 teams You may also send an email directly to Susie Mathieu.     Please enter your information: (Items in red are required) First Name   Middle Initial   Last Name   Nickname   Address   Address   City   State   Zip   Organization   Title   Work Phone (123) 456-0000 / Extension  Home Phone (123) 456-0000  Mobile Phone (123) 456-0000  Email Address (johnDoe@acme.com)  Comments   Select items of interest:     Running a FTC team  Sponsoring a team  Working on a FTC committee  Being a Regional FTC sponsor  Working on a First Robotics Competition (FRC) committee  Being a First Robotics Competition (FRC) sponsor