World Space Week 2003

"Build a Futuristic Human" Contest

Registration Form

Lubbock, Texas

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Print this form for entering the "Build a Futuristic Human" Contest, and submit it to the Museum Education Division office.

Museum of Texas Tech University Fourth Street and Indiana Avenue, Box 43191, Lubbock, Texas 79409-3191 Phone: (806)742-2432 Fax: (806)742-1136 Registration Form "Build a Futuristic Human" Name: ________________________________________________________ Address: ______________________________________________________ Home Phone #: ______________________ Age:_________ Grade: ________ School: _______________________________________________________ Teacher's Name: _______________________ School Phone #: __________ Date: _____________ Your Futuristic Human's name: "_____________________________________ _____________________________________________________________"