stanys state science congress approval form june 2,...

STANYS State Science Congress Approval Form June 2, 2018

To be Completed by the Student and Parent

a. Student Acknowledgement: I hereby certify that this entry represents my own original work. I have worked on my own or as part of a student team. Any assistance has been of an advisory nature. I have adhered to all local, state, national requirements where applicable for pre‐college research experimentation, including safety.

(Student Name) (Student Signature) (Date)

b. Parent/Guardian Approval: I have read and understand the risks and possible dangers involved in a research plan. I consented to have my child participate in this research.

(Parent/Guardian Name) (Parent/Guardian Signature) (Date)

To be completed by the Student’s School Advisor/Sponsor

I am familiar with the student’s research plan and to the best of my knowledge it adhered to all local, state, national requirements where applicable for pre‐college research experimentation, including safety and I approved this project.

This research was performed primarily using the facilities at (check one)

Home School University/college Research institute

Name of University, College, or Research Institute Name of the Advisor/sponsor's School Advisor/sponsor's position Phone number

(Advisor/Sponsor's Name) (Advisor/Sponsor's Signature) (Date)

To be Completed by the Student’s Research Mentor

The research involves: (Please check all that are appropriate.) Human Subjects (including surveys) Vertebrate Animals Controlled Substances

Potentially Hazardous Biological Agents (Projects incorporating microorganisms, rDNA technologies, or human or animal fresh tissues, blood or body fluids)

None of the above

This research was primarily preformed at:

(Name of University/college/research institute and location) I am familiar with the student’s research plan and to the best of my knowledge it adhered to all local, state, national requirements where applicable for pre‐college research experimentation, including safety and I approved this project.

Mentor's Position Phone Number

Mentor Name Mentor Signature Date

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Regional Science Congress Report June 2018 Use this form to forward the project information for the projects your fair is nominating to participate in the STANYS New York State Science Congress. Please use a separate form for the Junior and Senior Divisions. Use multiple forms if needed.

The number of entrants permitted from a STANYS Section to the STANYS State Science Congress shall be by the following formula.

1. Each Section of STANYS will be allowed to send three (3) entrants to the State Science Congress for up to 90 students competing at the Section level.

2. For every 30 students or fraction of it beyond the first 90 competing at the Section level, the Section may send one (1) additional entrant to the State Science Congress. (STANYS Board Policy modified 5/2013)

Regional Science Congress

Director of the Regional Congress

Phone number Email

Sponsored by STANYS Section

Entrant 1: Complete this section if the project was completed by an individual.

Check One: Junior Division Senior Division

Student Name School

Advisor



Student Name School

Advisor



Student Name School

Advisor

Complete this section if the project was completed by a team of students.


Advisor

Student Name School

Student Name School

Student Name School

Go on to the next page

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Payment Information

If you wish to nominate projects for the State Congress from another fair, a registration fee of $100

per student is required for participation in the STANYS State Congress Science Fair.

Please indicate who will be responsible for payment by checking the appropriate box.

School

Regional

Other Sponsor

Name of person responsible for payment

Phone

● Checks are to be written to: STANYS Western Section

● Checks with completed registration forms must be mailed by Friday, April 27, 2018 to: STANYS Western Section / Susan M. Sullivan

48 Wagon Wheel Drive East Amherst, NY 14051

Registration Fee Form June 2, 2018

There is a $100 per student registration fee required for participation in the STANYS State Science Congress. This fee may be paid for by the school or included as part of a prize package for a Section Science Congress, but it is not expected that students will be responsible for this cost. The responsible party should be indicated below. Please print

A registration fee of $100 per student is required for participation in the STANYS NYS Science Congress.

Payment will be made by (circle the appropriate organization at the right) School Regional Fair Other

Name of organization making payment __________________________________________________

Name of Person Responsible for payment________________________________________________

Phone Number of person making payment ____________________________________________

• Checks are to be written to : STANYS Western Section

• Checks must be mailed by Friday, April 27, 2018 to:

STANYS Western Section I Susan M. Sullivan

48 Wagon Wheel Drive, East Amherst, NY 14051

Please forward this form by Email to: [email protected]

Name of Student ______________________________________________________________ Student’s home phone number ( ) ________ _____________

mailto:[email protected]

STUDENT REGISTRATION & INFORMATION FORM June 2, 2018

Please type or neatly print on this form.

Student Information Student First Name I Last Name I Age I Sex I Grade

I I I I Home

Information Address I Street I I Home Phone:

I Town/Zip I I Email: Name of School School Address Street I I School Phone I

Town/Zip I I School Fax: I

Advisor Information Name Mr.,Mrs., Ms, Dr. I First Name I Last Name

I I Name of School School Address Street I I School Phone I

Town/Zip I I School Fax: I Email

Individual Project Information Name of Science Fair

Fair Director Typed or Printed Name: Signature:

STANYS Section Affiliation

Title of Presentation

Division (check ONE)

Senior Division (10-12) Biological Sciences Senior Division (10-12) Physical Sciences Junior Division (7-9) Biological Sciences

Junior Division (7-9) Physical Sciences

Email Abstract: Students must submit an abstract by Friday, April, 27, 2018 in Word or pdf format to [email protected] as well as bring 5 copies to the fair. It must include their name, title, and be no more than

250 words. It should not include your school, where you did your research, or your acknowledgements. You may bring a log book with data entries for judges to review. The State Science Congress will be a poster format. Students must have a free-standing storyboard of their project for the judges to review. WOODEN STRUCTURES WILL NOT BE

ALLOWED. You will only have a space of 30” deep and 4 ‘ wide to display your board. Each student will be given 10 minutes to present to the judge and the judge will have an opportunity to ask questions. You will have 4 different judges.


Team Projects: Complete this if your project was completed as a team. This form needs to be filled out once for the team but each student must complete the first page of the “Student Registration and Information”.

Team Project Information Science Fair





Senior Division (10-12) Biological Sciences

Senior Division (10-12) Physical Sciences

Junior Division (7-9) Biological Sciences Junior Division (7-9) Physical Sciences

Names of team members: Please print names 1. Team Leader _______________________________________ 2. Student 2 ___________________________________________ 3. Student 3 ___________________________________________ Please note that the registration fee is $100 for each student, this covers a chaperone. There is a fee of $50 for each additional guest. Please complete the “Chaperone and Guest Form”

Page 2

Morning coffee and snacks will be available at 7:45 am in the Student Union Lobby

The Awards Ceremony: It will take place in the theater of the Student Union following the afternoon program.

Finalist must be present at the Award Ceremony to receive the award. Refreshments will be served prior to awards.

New York State Science Congress 2018

I agree and do hereby give and assign to you, your successors and assigns, the irrevocable right to photograph my child at the New York State Science Congress 2018 June 2, 2018 and to reproduce, distribute , exhibit, televise, or otherwise exploit the photographs of him/her (alone or with others) in whole or in part (with right to crop, rearrange and superimpose) in any medium now or hereafter known or invented and to authorize others to do so for advertising , publicity, trade, entertainment, education, or otherwise, and to use these photographs or other likenesses in connection therewith, and to secure copyrights in all of such reproductions or prints.

I hereby certify that I have the right to give you the rights and permissions hereby conveyed.

Parent Signature _____________________________________ Date _______________________

Teacher/Advisor Approval

Please have your teacher/ advisor sign the following statement:

I, (advisor) do hereby certify that the work of (these) student(s) has been approved by me for entry into the New York State Science Congress 2018.

Teacher/ Advisor Signature__________________________________ Date ______________

STUDENT REGISTRATION & INFORMATION FORM June 2, 2018

Please type or neatly print on this form.

Student Information Student First Name I Last Name I Age I Sex I Grade

I I I I Home

Information Address I Street I I Home Phone:

I Town/Zip I I Email: Name of School School Address Street I I School Phone I

Town/Zip I I School Fax: I

Advisor Information Name Mr.,Mrs., Ms, Dr. I First Name I Last Name

I I Name of School School Address Street I I School Phone I

Town/Zip I I School Fax: I Email

Individual Project Information Name of Science Fair





Senior Division (10-12) Biological Sciences Senior Division (10-12) Physical Sciences Junior Division (7-9) Biological Sciences

Junior Division (7-9) Physical Sciences

Email Abstract: Students must submit an abstract by Friday, April, 27, 2018 in Word or pdf format to [email protected] as well as bring 5 copies to the fair. It must include their name, title, and be no more than

250 words. It should not include your school, where you did your research, or your acknowledgements. You may bring a log book with data entries for judges to review. The State Science Congress will be a poster format. Students must have a free-standing storyboard of their project for the judges to review. WOODEN STRUCTURES WILL NOT BE

ALLOWED. You will only have a space of 30” deep and 4 ‘ wide to display your board. Each student will be given 10 minutes to present to the judge and the judge will have an opportunity to ask questions. You will have 4 different judges.


Team Projects: Complete this if your project was completed as a team. This form needs to be filled out once for the team but each student must complete the first page of the “Student Registration and Information”.

Team Project Information Science Fair





Senior Division (10-12) Biological Sciences

Senior Division (10-12) Physical Sciences

Junior Division (7-9) Biological Sciences Junior Division (7-9) Physical Sciences

Names of team members: Please print names 1. Team Leader _______________________________________ 2. Student 2 ___________________________________________ 3. Student 3 ___________________________________________ Please note that the registration fee is $100 for each student, this covers a chaperone. There is a fee of $50 for each additional guest. Please complete the “Chaperone and Guest Form”

Page 2

Morning coffee and snacks will be available at 7:45 am in the Student Union Lobby

The Awards Ceremony: It will take place in the theater of the Student Union following the afternoon program.

Finalist must be present at the Award Ceremony to receive the award. Refreshments will be served prior to awards.

New York State Science Congress 2018

I agree and do hereby give and assign to you, your successors and assigns, the irrevocable right to photograph my child at the New York State Science Congress 2018 June 2, 2018 and to reproduce, distribute , exhibit, televise, or otherwise exploit the photographs of him/her (alone or with others) in whole or in part (with right to crop, rearrange and superimpose) in any medium now or hereafter known or invented and to authorize others to do so for advertising , publicity, trade, entertainment, education, or otherwise, and to use these photographs or other likenesses in connection therewith, and to secure copyrights in all of such reproductions or prints.

I hereby certify that I have the right to give you the rights and permissions hereby conveyed.

Parent Signature _____________________________________ Date _______________________

Teacher/Advisor Approval

Please have your teacher/ advisor sign the following statement:

I, (advisor) do hereby certify that the work of (these) student(s) has been approved by me for entry into the New York State Science Congress 2018.

Teacher/ Advisor Signature__________________________________ Date ______________

stanys state science congress approval form june 2,...

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