th
5
Annual Kent County Science
Fair Application Form
Student Information
Last Name: __________________________________ First Name: ________________________________ M.I.________
E-Mail Address: ___________________________________________ Home Phone: ______________________________
Home Address: ____________________________________________________City: _____________________________
State: ________________ Zip Code: ______________ Grade: ________ Age: _________ Gender: Male
Female
I hereby grant permission to the Kent County Science Fair and/or its associates or assistants to
photograph/film/interview my child, _______________________________________________ and use their name,
likeness, and/or biographical information. I understand that photographs, films and interviews (names, likeness, and
biographical information) or portions thereof will be used for public view (publications, multimedia production, display,
advertisement and/ or on the World-wide web.
Parent/Guardian Signature (press release): ______________________________________________________________
School and Teacher Information
School Name: ______________________________________________________________________________________
Teacher/Sponsor: __________________________________ E-mail Address: ____________________________________
School Address: _____________________________________________________________________________________
City: ____________________________________ State: ______________________ Zip Code: ______________________
School Phone: ____________________________________ School Fax: ________________________________________
Teacher/Adult Sponsor Signature (press release): __________________________________________________________
Project Information
Title of Project: _____________________________________________________________________________________
Category #: ___________________________________ Check One: Individual _______________ Team ______________
1.
Animal Science
9.
Energy & Transportation
2.
Behavioral and Social Science
10. Environmental Management
3.
Biochemistry Cellular & Molecular Biology
11. Environmental Sciences
4.
Chemistry
12. Mathematical Sciences
5.
Computer Science
13. Medicine and Health
6.
Earth Science
14. Microbiology
7.
Engineering: Electrical & Mechanical
15. Plant Sciences
8.
Engineering: Materials & Bioengineering
16. Physics and Astronomy
Team Members: ____________________________________________________________________________________
All team members’ applications MUST BE submitted together
ALL APPLICABLE FORMS MUST ACCOMPANY THIS APPLICATION
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