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ST. JAMES PARISH SCIENCE AND ENGINEERING FAIR JR. / SR. DIVISION ENTRY FORM Circle One: INDIVIDUAL / TEAM Please type or print all information. Name(s)________________________________ Grade__________ Home Address_________________________ City_______________________ Division: ________Senior (Grades 9-12) Category: Check One ___Animal Sciences ___Cellular and Molecular Biology ___Earth & Planetary Science ___Energy and Transportation ___Mathematical Sciences ___Physics and Astronomy Phone_________________ Zip_______ _______Junior (Grades 6-8) ___Behavioral & Social Sciences ___Chemistry ___Engineering: Electrical & Mechanical ___Environmental Management ___Medicine & Health Sciences ___Plant Sciences ___Biochemistry ___Computer Science ___ Engineering: Materials & Bioengineering ___Environmental Sciences ___Microbiology Title of Exhibit______________________________________________________________________ Description of Project_________________________________________________________________ ___________________________________________________________________________________ ___________________________________________________________________________________ Exhibit Size and Weight: (Maximum: Width-48”; Depth-30”; Height-108” Weight-100 pounds) Width_______inches Depth_____inches Free-Standing Project: ___Yes ___No Height________inches Electricity Needed: Were live vertebrate animals or humans used? ___Yes Certifications must be attached to the entry form. ___Yes Weight_________pounds ___No ___No. If yes, COPIES of Protocols and I AGREE TO ABIDE BY ALL WRITTEN AND/OR VERBAL RULES, REGULATIONS, AND INSTRUCTIONS GIVEN BY THE FAIR DIRECTOR AND REALIZE THAT MY PROJECT MAY BE RULED INELIGIBLE FOR COMPETITION, AND/OR INELIGIBLE TO RECEIVE AWARD(S), AND/OR AWARD(S) REVOKED IF I DO NOT COMPLY. I CERTIFY THAT THIS PROJECT WAS MY WORK ALONE. I AGREE TO REGISTER AND SET UP MY PROJECT THE DAY BEFORE THE SCIENCE FAIR AND REMOVE MY PROJECT THE DAY OF THE FAIR AFTER JUDGING. EXHIBITOR’S SIGNATURE___________________________________________________________ I CERTIFY THAT THE ABOVE NAME STUDENT DID THIS PROJECT UNDER MY SUPERVISION OR AS NOTED ON THE ATTACHED CERTIFICATIONS REQUIRED FOR VERTEBRATE OR HUMAN RESEARCH. TEACHER’S SIGNATURE_____________________________________________________________ Send a copy of entry form (1A) Research Plan Form, (1B) Approval Form, ISEF Abstract Form and any additional mandatory forms as applicable to the project on or before Friday, January 9, 2015 to: St. James Parish Science and Engineering Fair St. James Parish School Board Office Attention: Renee’ Hartley P. O. Box 338, Lutcher, LA 70071 2014-15 Note: Teacher keeps all original forms on file. ST. JAMES PARISH SCIENCE FAIR ELEMENTARY DIVISION GRADES 1-5 ENTRY FORM Circle One: INDIVIDUAL / TEAM PLEASE PRINT NAME (s)_____________________________________________ GRADE_________________________ SCHOOL___________________________________________ AGE________________________ SCHOOL MAILING ADDRESS___________________________________________________________ TEACHER’S NAME____________________________________________________________________ TITLE OF PROJECT____________________________________________________________________ BRIEF DESCRIPTION OF PROJECT______________________________________________________ ______________________________________________________________________________________ ______________________________________________________________________________________ APPROXIMATE SIZE OF EXHIBIT: FRONT TO BACK_________________INCHES MAX. 30 INCHES SIDE TO SIDE_________________INCHES MAX. 48 INCHES HEIGHT_________________INCHES MAX. 108 INCHES WEIGHT_________________POUNDS MAX. 100 POUNDS ELECTRICITY REQUIRED: _____ YES _____ NO I AGREE TO ABIDE BY ALL WRITTEN AND/OR VERBAL RULES, REGULATIONS, AND INSTRUCTIONS GIVEN BY THE FAIR DIRECTOR AND REALIZE THAT MY PROJECT MAY BE RULED INELIGIBLE FOR COMPETITION, AND/OR INELIGIBLE TO RECEIVE AWARD(S), AND/OR AWARD(S) REVOKED IF I DO NOT COMPLY. I AGREE TO REMOVE MY PROJECT IMMEDIATELY AFTER JUDGING THE DAY OF FAIR. Forms are due to district office by or before Friday, January 9, 2015. 1 copy of student’s abstract(description of project) must accompany this entry form. St. James Parish Science and Engineering Fair/St. James Parish School Board Office Attention: Renee’ Hartley P. O. Box 338, Lutcher, LA 70071 _______________________________________ EXHIBITOR’S SIGNATURE(s) 2014-15 ______________________________________ TEACHER’S SIGNATURE Note: Teacher keeps all original forms on file.