2024 MS Region I Science and Engineering Fair School Registration Form

This form needs to be filled out by every school interested in participating in the Region I Science and Engineering Fair. Please be as accurate as possible when estimating attendance as it helps with determining final ISEF participation.

School Name*

School District*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

Phone number*

Estimated number of Science Fair Projects*

School Type *

(Public/Private/Home/Other):

Part II. Committee Information

Name of Local SRC Chairperson*

First Name

Last Name

Title*

Email*

Address*

Address Line 1

Address Line 2

City

State

ZIP Code

SRC Member 2

First Name

Last Name

Title

SRC Member 3

First Name

Last Name

Title

Name of Local IRB Chairperson*

First Name

Last Name

Title *

Address *

Address Line 1

Address Line 2

City

State

ZIP Code

IRB Member 1

First Name

Last Name

Title

IRB Member 3

First Name

Last Name

Title

Key Teacher Certification

I have reviewed the form(s) for both correctness and completeness. I further certify that (1) this project follows all proper procedures involving humans and/or vertebrates, (2) that school officials pre-approved the questionnaire(s), and that I and others in the school take full legal and ethical responsibility for both the questionnaire and its use in human research, and (3) that the research behind the project and display represent this student's work. I therefore certify this registration to be a complete, authorized entry in the current year's Regional MSEF Fair.

Terms and Conditions Acknowledgement*

I agree to your terms and conditions listed above.

Key Teacher’s Name*

First Name

Last Name

Key Teacher’s Signature*

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