2014 Pennsylvania Science Olympiad Registration Form
Please complete all items. Use "tab" or mouse clicks to move between fields. Note: Date Change for Central and Southwestern Regional Tournaments
Choose Appropriate Region:
If you are unsure of your region see list of counties for each region on registration page.
NW (Northwestern) @ Penn State Erie
C (Central) @ Millersville University
NE (Northeastern) @ Penn State Wilkes Barre
CE (Central Eastern) @ Kutztown University
SW (Southwestern) @ California University of PA
SE (Southeastern) @ Neumann University
Choose Appropriate Division:
B (Grades 6-9)
C (Grades 9-12)
Specific School Information
Your specific and complete school name, not the district. Thanks
School Phone number and extension:
###-###-### x ###
School Street Address:
Number of Years your school has been in Science Olympiad
Returning after at least a 5 year absence
Primary Contact Coach:
First & Last Name (example: Roger Demos). Please list the coach that is the primary contact first.
Primary contact coach phone number
Please list the preferred phone number to use to reach the primary coach outside of school.
Primary Contact Coach: School email:
If the team has more than one coach who should receive emails, list multiple emails with a semicolon in-between.
Non-school email address please. This is needed because many schools block bulk emails. If the team has more than one coach who should receive emails, list each email with a semicolon in-between.
Other Team Coaches
If you would like other coaches in our database, please list their name and contact information
Each Team is REQUIRED to provide at least 1 event supervisor/judge
Name of Primary supervisor/judge:
This does not have to be the coach, it can be another adult.
Please indicate whether this person would prefer to serve as an event supervisor or judge
Event Supervisors qualify for Act 48 credit. Event Supervisors write (where applicable), set-up and run the event.
Email contact for this person
Phone number for this person
Preferred subject area:
If your school desires to assist with more than one event please provide the names, contact information and preferred events in the space provided.
Within 3 school days after this form has been submitted, the primary coach will receive a confirmation email and a payment voucher to be printed and included with a check for the registration fee.
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