Science Fairs Alumni Community Supported by Merck
1. Identification
First Name
Your answer
Last Name
Your answer
Email
Your answer
2. Postal address
Civic no.
Your answer
Street name /App. no.
Your answer
City
Your answer
Province/State:
Your answer
Country
Your answer
Postal Code
Your answer
Home phone number
Your answer
Work phone & ext.
Your answer
Cell. phone
Your answer
Date of Birth
MM
/
DD
/
YYYY
Gender
2. Academic and professional information
Have you studied in science or technology
Required
Did your participation in the Science Fair kickstart your career?
Required
Which degree(s) have you completed? Add all degrees or certificates completed or in progress.
Your answer
Have you been employed in jobs related to science or technology?
Current employment status
Current employer
Your answer
Job title
Your answer
3. Science Fair experience
Please select the region of the science fair in which you took part
Enter all the years you participated in the science fair, in any capacity.
Example : Local final 2000 - 2 regional finals ( 2000 and 2001) - Quebec Final , etc
Your answer
When participating in the Science Fair, did you win any awards or scholarships?
Required
How did you learn of the Science Fairs Alumni Community? (check all options which apply)
If you selected "Other Internet site" or "Other" please specify it here
Your answer
Other than your carrier choice and path, what do you recall most of your participation in the Science Fair (personal development, friendships, experiences, etc.)
Your answer
4. Volunteer to support the Science Fair Progam
Would you like to support the Science Fair program as a volunteer
If yes, the Réseau Technoscience will contact you by email.
5. Forwarding of information to Réseau Technoscience partners
I understand that by submitting this form, my answers will be forwarded to the partners of the Réseau Technoscience, comprised of the eight regional affiliates, and the Education Alliance for Science and Technology (EAST). I accept that my data be used for statistical purposes. I understand that I may receive newsletters regarding activities organized by the Réseau Technoscience, the organization responsible for Quebec’s Science Fairs, as well as invitations regarding activities related to the Science Fairs. I also understand that my data will be protected and that it will never be shared with or sold to third-parties. For more information, I can consult the "Politique de protection des renseignements personnels” of the Réseau Technoscience.
I accept the conditions of the registration form for the Science Fairs Alumni Community Supported by Merck
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