2016 Synopsys Sacramento Regional STEM Fair

2016 Synopsys Sacramento Regional STEM Fair

Student Project RegistrationTemplate

Students in grades 6-12 are eligible to compete; students in grade 5 are showcase ONLY.

IMPORTANT! BEFORE YOU START:

Please review the Intel International Science & Engineering Fair Rules & Guidelines here.
Your registration needs to be complete PRIOR to experimentation.
All additional forms can be downloaded, and then uploaded on the online registration. It saves a LOT of time to do them beforehand. Use the Roadmap to Registration here to see what additional forms you need.
If you DO NOT want to compete please be sure to use the Novice Division registration.
If you have any questions/issues, please contact staff at .

STUDENT INFORMATION

FullName:______

Please write the way your name sounds:______

Gender: Female Male

Ethnicity:

YourE-mail:______@______

Your T-shirt Size (All T-shirts in AdultSizes):XL L M S

A parent'sname:______

A parent'semail:______@______

HomeAddress: ______City:______Zip Code:______

Home PhoneNumber:______-______-______

YourGrade:______

YourSchool: ______

School'sAddress: ______City:______Zip Code:______

Teacher'sName:______

Teacher'sEmail:______@______

Is your School a Project Lead the Way (PLTW)Participant?:

Yes No Not sure

PROJECT INFORMATION

ProjectTitle:

CompetingCategory:

Behavioral & Social Sciences

Biological Sciences

Chemistry & Health Sciences

Energy & Transportation

Engineering

Math & Computer Sciences

Physical Sciences

How many students (including yourself) will be working on yourproject?123

My Project isa...Individual ProjectTeam Project

TEAM PROJECT

If you are doing a team project, you will need to provide the following information:

Team member 1’s Name:______

Please write the way their name sounds:______

Team member 1’s Gender:Female Male

Team member 1’s Ethnicity:

Team member 1’s Email:______@______

Team member 1’s T-shirt Size: XL L M S

Team member 2’s Name:______

Please write the way their name sounds:______

Team member 2’s Gender: Female Male

Team member 2’s Ethnicity:

Team member 2’s Email:______@______

Team member 2’s T-shirt Size:XL L M S

RESEARCH OUTLINE

Abstract:

BackgroundResearch:

Hypothesis:

MaterialsList:

Proceduralsteps:

Bibliography:

Is this a Continuation Project from lastyear?:YesNo

Where will you conduct your experimentation? (Check all thatapply):

Research Institution

School

Home

Other

THE PROJECT INVOLVES (CHECK ALL THAT APPLY)

During my experimentation I will interview, observe, orinvolve:

Humans

Requires three additional forms:

Human Participants Form (4)

Sample of Informed Consent Form (when applicable – i.e. Surveys, interviews, non-anonymous observation)

Qualified Scientist Form (2)

Vertebrate Animals

Requires two to three additional forms:

Vertebrate Animal Form (5A)—for projects conducted in a school/home/field research site

Vertebrate Animal Form (5B)—for projects conducted at a Regulated Research Institution. (Required prior to experimentation)

Qualified Scientist Form (2)

During my experimentation I will test, use,involve:

Potentially Hazardous Biological Agents (Microorganisms and/or rDNA, etc)

Requires three to four additional forms:

Potentially Hazardous Biological Agents Risk Assessment Form (6A)

Human and Vertebrate Animal Tissue Form (6B)—to be completed in addition to Form 6A when project involves the use of fresh or frozen tissue, primary cell cultures, blood, blood products and body fluids.

Qualified Scientist Form (2)

Risk Assessment Form (3) required for projects involving protists, archae and similar microorganisms, for projects using manure for composting, fuel production or other non-culturing experiments, for projects using color change coliform water test kits, microbial fuel cells, and for projects involving decomposing vertebrate organisms.

Human or Vertebrate Tissues

Requires three additional forms:

Potentially Hazardous Biological Agents Risk Assessment Form (6A)

Qualified Scientist Form (2)

During my experimentation I will use or be in close quarterswith:

Potentially Hazardous Chemicals, Activities or Devices

Requires two additional forms:

Qualified Scientist Form (2)

You can find the above mentioned additional forms online using the Roadmap to Registration.

QUALIFIED SCIENTIST FORM

Important: You only need to fill out this form if you need additional paperwork. IF you are submitting a Novice Division, showcase only project you will not need this form. You will need the Supervising Adult form below.

FullName:______

EducationalBackground:______

Degree(s):______

Experience/trainingrelated to thestudent'sarea ofresearch:

Position:______

Institution:______

Address:______City:______Zip Code:______

PhoneNumber:______-______-______

Have you reviewed the Intel International Science & Engineering Fair rules relevant to thisproject?

Yes

Will any of the following beused?

Human participants

Vertebrate Animals

Potentially Hazardous Biological Agents (Microorganisms, rDNA, tissues – including blood and blood products)

DEA-controlled substances

Was this study a sub-set of a largerstudy?

Yes

Will you directly supervise thestudent?

Yes

Signature: ______

SUPERVISING ADULT FORM

This form is ONLY for the Novice Division applicants.

FullName:______

EducationalBackground:______

Degree(s):______

Experience/trainingrelated to thestudent'sarea ofresearch:

Position:______

Institution:______

Address:______City:______Zip Code:______

PhoneNumber:______-______-______

Will any of the following beused?

Human participants

Vertebrate Animals

Potentially Hazardous Biological Agents (Microorganisms, rDNA, tissues – including blood and blood products)

DEA-controlled substances

By signing this form you are agreeing to supervise the student during their experimentation period to ensure that no dangerous outcomes avail.

Signature: ______

REQUIRED SIGNATURES

Rules of Conduct and Release

Please read carefully, obtain proper signatures and return. ALL participating students are required to return this form to participate in the 2016 Synopsys Sacramento Regional Science & Engineering Fair.

Rules of Conduct

Scientific fraud and misconduct are not condoned at any level of research or competition. Such practices include plagiarism, forgery, use or presentation of other researcher’s work as one’s own and fabrication of data. Fraudulent projects will fail to qualify for the Synopsys Sacramento Regional Science & Engineering Fair.
The use of tobacco products, alcoholic beverages and/or drugs is prohibited.
Respect and maintenance of school property is required at all times.
Appropriate attire is expected. Please plan to wear casual business attire for the award ceremony held on Saturday evening after the Fair.
Attendance is mandatory during student interviews and at the public exhibition of projects on Saturday.

I have read and understand the above rules and agree to adhere to them to the best of my ability. I understand that a consequence of failure to meet these standards may be that I will be sent home immediately at my parents’ expense.

Parent/ Guardian Signature:______

Student Signature:______

Liability for Exhibits

Every effort will be made to protect exhibits from loss or damage. However, since the exhibition of projects at the Synopsys Sacramento Regional STEM Fair (Event) is open to the public, the Sacramento Regional Science & Engineering Fair Foundation cannot and will not accept any liability or responsibility of any nature for any theft, loss or damage to any exhibit or any other property of any Exhibitor. "Exhibitor" is defined as student participant, "exhibit" is defined as student projects. Accordingly, it is recommended that each Exhibitor take all prudent precautions to prevent any theft, loss or damage to his/her exhibit and/or other property. Each Exhibitor should secure and guard his/her exhibit and/or other property at all times during the Event, and remove all valuable components, especially those that are easily portable, when the exhibit and/or other property is left unguarded by the Exhibitor.

I have read the above paragraph, and understand and accept the Sacramento Regional Science & Engineering Fair Foundation cannot and will not accept any liability or responsibility for theft or damage to my exhibit.

Parent/ Guardian Signature:______

Student Signature:______

Publicity

Organizations and businesses sponsoring awards at the Synopsys Sacramento Regional Science & Engineering Fair ("Event") may wish to publicize their involvement in the Event, which may include reports of achievements at the competition by using photographs or information about you. We request your availability and cooperation when contacted, interviewed, photographed and videotaped by the media before, during and after the Event. In addition, limited travel to local media outlets within the Sacramento Regional Science and Engineering Fair Foundation region may be necessary to accommodate interview requests. Advance notice will be given. Your cooperation is requested for the full duration of the fair cycle beginning with your local school or district fair through the Event and after the Intel ISEF (approximately 10 months).

Appropriate information about me may be used for publicity purposes. This includes photographs submitted by me as well as any photographs, videos or likenesses that may be used by the Sacramento Regional Science and Engineering Fair Foundation or the sponsors of awards for the purposes of illustration, advertising or publication in any manner. I also consent to the use of my name in connection therewith and agree that I will cooperate with regard to all publicity in connection therewith for the duration of the Fair cycle.

Parent/ Guardian Signature:______

Student Signature:______

****OPTIONAL****

Starting in 2013, students who wish to compete at the Intel International Science and Engineering Fair (Intel ISEF), Intel Science Talent Search (Intel STS) and local and regional SSP-affiliated science fairs must register as a Student Member of SSP. Doing so will also allow you to receive digital badges that validate and commemorate your participation in any SSP-affiliated or SSP-Intel science competition. Student members also receive the Society’s newsletters and other relevant communications about science fair activities.

If you wish to sign up, please register at:

Congrats! You’ve done it!

Now you are ready to begin entering the information you’ve completed here online.

Begin online student project registration (Competing)

Begin online student project registration (Novice Division)