Registration Form

for COLLABORATIVE Science Projects

* = required!

             MY NAME is:*

              My age is:* My grade in school is: *

   My e-mail address is:*

Deadline project is due:*
    
       My school's name: 
    
       School's address:
           More address:
           More address:
        City/state*/zip:

 City/country/mail code:

      My teacher's name:

    Teacher's e-address:

What is your science interest area?*

Check all that apply to you:

1. I am more than 12 years old.

2. I have done a previous science project, which is summarized in the box below.

3. I want to help someone who already has a project.

4. My project needs helpers to do...(see below)

5. I need widely scattered helpers in the locations listed below.

6. My group has results to report. Our summary is below.

7. I have no idea what I want to do.

8. I live in a rural area.

9. I live in a city of more than 1 million people.

10. I live in a town or small city.

11. I live near a college or university.

REQUIRED: My thoughts on what I would like to do, and on what projects I have done in the past:

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