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Illinois Junior Academy of Science Region 8 Registration Form
Please fill out this form for each student. If you have any questions, please do not hesitate to email me at
siu447@siu.edu
. The form will be sent directly to me as an excel form. Register all students before March 4th.
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* Indicates required question
School Name
*
Your answer
Sponsor's Name
*
Your answer
IJAS Number
*
Your answer
First Student's Name (First Name first, Last Name second)
*
Your answer
First Student's Address (Street, City, Zipcode)
*
Your answer
First Student's Grade
*
Choose
7
8
9
10
11
12
Number of Students on Project (If 2 students are on the project, you must fill in the next two boxes)
*
Choose
1
2
Second Student's Name (First Name first, Last Name second)
Your answer
Second Student's Address (Street, City, Zipcode)
Your answer
Judging Category
*
Choose
Aerospace
Astronomy
Behavioral Science
Biochemistry
Botany
Cellular & Molecular Biology
Chemistry
Computer Science
Consumer Science
Earth Science
Electronics
Engineering
Environmental Science
Health Science
Materials Science
Mathematics
Microbiology
Physics
Zoology
Classification (See Handbook)
*
Choose
Design
Experimental
Project Title (No more than 80 characters including spaces)
*
Your answer
State (If project is chosen, student can go to state)
*
Please note: The State Science Fair will be held in Northern Illinois Univeristy. (approximately 350 miles from Carbondale)
Yes
No
Agricultural Related (Project is related to agriculture.)
*
Yes
No
Hispanic American (If more than one student on project both must be Hispanic American)
*
Yes
No
African American (If more than one student on project both must be African American)
*
Yes
No
Woman (If more than one student on project both must be women)
*
Yes
No
Disabled (If more than one student on project both must be disabled)
*
Yes
No
Boy Scout (a current Boy Scout with a minimum rank of 2nd Class)
*
Yes
No
Girl Scout ( a current Girl Scout Cadette, Senior,or Ambassador)
*
Yes
No
Student Meeting (Student would like to attend student meeting - no more than four students per school)
*
Yes
No
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