2011 CAPITAL REGIONAL SCIENCE & ENGINEERING FAIR Friday, February 4th, 2010, 8:00 a.m. - Noon Tully Gym

Full Name: ( Dr. Ms. Mr. )

University ______Governmental Agency: ______

Position: ____ Faculty ____ Post Doc ____ Grad Student Other ______

E-mail address: Daytime phone:

Work Mailing Address (include mail code):

I. PLEASE INDICATE WHICH GRADES YOU WOULD LIKE TO JUDGE:

____ Middle school ____ High school ____ Either

II. PLEASE INDICATE THE CATEGORIES YOU FEEL QUALIFIED TO JUDGE

Regular Category Judging (Friday, Feb. 4th, 2010, 8:00 to noon.)

____ Animal Sciences ____ Energy and Transportation ____ Behavioral & Social Science ____ Environmental Management ____ Biochemistry ____ Environmental Sciences ____ Cellular and Molecular Biology ____ Mathematics ____ Chemistry ____ Medicine and Health ____ Computer Science ____ Microbiology ____ Earth and Planetary Science ____ Physics and Astronomy ____ Engineering: Electrical &Mechanical ____ Plant Sciences ____ Engineering: Materials and Bioengineering

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Yes, I will be staying for the lunch served at approximately 11:30 a.m.

No, I will not be able to stay for the lunch.

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