Barcode Long Island Campaign Proposal Form
Total Page：16
File Type：pdf, Size：1020Kb
Barcode Long Island Campaign Proposal Form
Please fill in all information below to participate in a Barcode Long Island campaign.
Note that collection locations are not guaranteed, but will be approved on a first come, first served basis. Multiple teams from a school are welcome to be a part of campaigns, but must fill out separate proposal forms. In this case, please be sure teams collect visibly different organisms, collect from different locations, and/or participate in different campaigns. Teams that participate in a campaign are strongly encouraged to collect 20 samples. Biographies for all team members must also be submitted with this form.
Team Name:
Project Title:
Team Members:
School:
Campaign (please select one):
__ __ Beetles __ __ Ants __ __ Mosquitoes __ __ Marine worms (NOT terrestrial worms) __ __ Aquatic (freshwater) macroinvertebrates (ex: insect larvae)
Collection Location(s) – please describe:
Latitude: Longitude:
Briefly describe your project goals, and relevance to human health: Please describe the collection methods for your samples:
For each team member and mentor, please include the following information:
Student 1
Name:
Present grade (9th, 10th, 11th or 12th grade):
School/institution:
State/ZIP:
Brief biography:
Student 2
Name:
Present grade (9th, 10th, 11th or 12th grade):
School/institution:
State/ZIP:
Brief biography:
Student 3 (if applicable)
Name:
Present grade (9th, 10th, 11th or 12th grade):
School/institution:
State/ZIP:
Brief biography: Student 4 (if applicable)
Name:
Present grade (9th, 10th, 11th or 12th grade):
School/institution:
State/ZIP:
Brief biography:
Mentor
Name:
School/institution:
State/ZIP:
Brief biography: