The Ohio Academy of Science-State Science Day Judges Registration Form 

 

Please complete this form ONLY if you are able to serve as a Judge on Saturday, May 11, 2013 at The Ohio State University.

 

NOTE: We welcome colleagues, spouses, and friends to judge or be general volunteers.

See volunteer link at ssdvolunteer

 

The general schedule for State Science Day is linked here: http://www.ohiosci.org/SSD2013Schedule.pdf

 

NOTE:  Please use the TAB key to move between fields. The enter key will submit the form. Use the SUBMIT FORM button at the bottom of the page to submit the completed form.

Please provide the following information:

Title        	       
Full Name         
Job Title   	       
Organization     
Mailing Address 
Address (cont.) 
City                  
State                
Zip                   
Ohio County

 

Is this a home address?    Yes No

 

Work Phone.     Extension 
Home Phone    
FAX                
E-mail             
Retype E-mail

Please choose one of the following options:

Please select ONLY your TOP FIVE, ranked 1 (top choice) through 5 (last choice)--

your willingness and expertise to judge in these areas:

 Behavioral & Social

 Biochemistry 

 Botany 

 Chemistry 

 Computer Science 

 Earth & Space Sciences 

 Engineering 

 Environmental Sciences 

 Mathematics 

 Medicine & Health Sciences 

 Microbiology 

 Physics 

 Zoology 

 

Highest Degree Earned:

Is this your first time to judge

at State Science Day?  Yes No

 

If you have judged at least two of the past five years at State Science Day,

    are you willing to help with rejudging projects? yes no

 

Did you attend State Science Day as a student?

Yes No  If yes, what year(s)?

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Copyright © 2010 The Ohio Academy of Science. All rights reserved.
Revised: 04/24/2013