LMTA Keyboard Olympics Registration Form
Student Name
*
First Name
Last Name
School Grade
*
K
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Adult
Student Email
example@example.com
Level
*
Preparatory
Level 1
Level 2
Level 3
Level 4
Level 5
Level 6
Teacher Name
*
First Name
Last Name
Teacher Email
*
example@example.com
Teacher Cell Phone
*
-
Area Code
Phone Number
Teacher Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Select your local affiliate:
*
BRMTA
CENLA
GSMTA
LAMTA
LCMPTA
MDMTA
NOMTA
NSMTA
RAMTA
None
Enter the message as it's shown
*
My Products
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All THREE Events
$50.00
$
50.00
Spontaneous Events
$20.00
$
20.00
Prepared Events
$20.00
$
20.00
Creative Events
$20.00
$
20.00
Total
$0.00
$
0.00
Payment Methods
Debit or Credit Card
Choose from one of the PayPal options to
make your payment.
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