Do you have any conflicts of interest with any regional school district or student? Yes No

If yes please list them:


PLEASE SEND ALL CORRESPONDENCE TO: 

Home Business
 

Name:                        

Home Address:         

City & Zip:                         

Home Phone:                

 

Company:                  

Department:             

Address:                         

City & Zip:                     

Phone:                                                                       

 

Degree:          Degree Subject:

E-mail:

 

 

Will you be a judge this year?  Yes     No                       Will you be a captain?   Yes     No

 

Circle the division you prefer to judge:     I (grades 4-8)    II (grades 9-12)   EITHER

 

Circle the type of projects you prefer to judge:        INDIVIDUAL     TEAM         EITHER

 

Please indicate the areas you wish to judge. You may check them for arbitrary rankings or include numbers to indicate order of preference (up to 4 choices).

 

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