ɴᴇʙᴜʟᴀ ᴅᴇʟᴇɢᴀᴛɪᴏɴ ʀᴇɢɪꜱᴛʀᴀᴛɪᴏɴ ꜰᴏʀᴍ
ミ★ 𝘌𝘢𝘳𝘭𝘺 𝘉𝘪𝘳𝘥 𝘋𝘦𝘢𝘥𝘭𝘪𝘯𝘦: 25𝘵𝘩 Octobe𝘳 ★彡
Will you be registering an entire team?
Yes
No, I'd like to opt for the Fusion Delegation Program
Head Delegate Information
Full Name of the Head Delegate
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Grade
*
Please Select
O1
O2
O3
As
A2
Inter
Ambassador Name (If any)
Register as an ambassador by filling the form!
School Name (If any)
example schooling system
General Information
What is the name of your Team?
*
How many members are in the Delegation?
*
5
6
Team Information
Full Name of Delegate # 2
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Grade
*
Please Select
O1
O2
O3
As
A2
Inter
Full Name of Delegate # 3
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Grade
*
Please Select
O1
O2
O3
As
A2
Inter
Full Name of Delegate # 4
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Grade
*
Please Select
O1
O2
O3
As
A2
Inter
Full Name of Delegate # 5
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Grade
*
Please Select
O1
O2
O3
As
A2
Inter
Full Name of Delegate # 6
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Grade
*
Please Select
O1
O2
O3
As
A2
Inter
Fusion Delegation Registration
~
How many members would like to sign up for the Program?
1
2
3
4
Ambassador Name (if any)
School Name (if any)
Full Name of Delegate # 1
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Grade
*
Please Select
O1
O2
O3
As
A2
Inter
Full Name of Delegate # 2
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Grade
*
Please Select
O1
O2
O3
As
A2
Inter
Full Name of Delegate # 3
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Grade
*
Please Select
O1
O2
O3
As
A2
Inter
Full Name of Delegate # 4
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Grade
*
Please Select
O1
O2
O3
As
A2
Inter
Back
Next
Module Selection
Acknowledge our Pool A compulsory module.
*
Physics - Photon Phrenzy
Acknowledge our Pool B compulsory module.
*
Mystery -Crimson Masquerade
What other module will be chosen from Pool A? Note: Gaussian Gateway has been sealed.
*
Chemistry - Quantronexus
Computer Science - ParalogiX
Biology - Cytocycle
What other module will be chosen from Pool B?
*
Astronomy - Andromeda's Gaze
Psychology - Psychlone
Payment Information
Failure to pay within 10 hours will result in your registration getting cancelled
Payment Options
*
Cheque
Pay Order
Online Transfer
Cash
Do you agree to abide by all guidelines set by Nebula. (Viewable on our website)
*
Yes
We will contact you soon!
Thank you!
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