2008-2009 Glen Landing MIddle School Science Fair Application Form
Due : With Topic Selection 3x5 Card. Cut and paste this information into microsoft word and complete the form. This
may also be printed and filled out.
Student Name :
Grade :
Science Teacher :
Names of Team Members: (if doing a group project)
Title of Project:
__________________________________________________________________________________
Project Number
(if known) :
Student Acknowledgment: I understand the risks and possible
dangers to me for the Topic I have selected.
Will your project
involve any of the following areas? (Please specify and explain below.)
q
Chemicals
(hazardous, flammable, explosive, highly toxic, carcinogens, mutagens, pesticides)
q Electronic Equipment (welders,
lasers, voltage >220 volts)
q Human Subjects
q Nonhuman Invertebrates
q Pathogenic Agents (bacteria, fungi)
q Controlled Substances
q Recombinant DNA
q Human or Animal Tissue
q Firearms
q
Radiation
or Radioactive Substances
Explain
here if any items are checked off :
student’s
printed name and date :
student’s
signature :
Parent/Guardian
Approval: I have read and understand the risks and possible dangers involved with
the Topic my child has selected
parent/guardian printed name and date
parent/guardian signature
