FORT ATKINSON SCIENCE FAIR ENTRY FORM

       (Please print clearly or type in all lines except where noted)

                Entries due no later than January 31, 2008

Mail to:                                                                 Turn in:

Karen Kutz                                                             Dwight Foster Public Library

W.D. Hoard & Sons                                             102 Milwaukee Ave. E.

28 W. Milwaukee Ave.                                        Fort Atkinson, WI 53538

Fort Atkinson, WI 53538

Name of Entrant or Team:________________________________________________________________________

Project Title:___________________________________________________________________________________

The question your project will try to answer:_________________________________________________________

School: ____________________________________ School Phone: ________________________ Grade: _______

Home Address:________________________________________________________________________________

City _______________________________________Zip Code: __________________________

Home Phone: _____________________________________________________

Grade Division (Check one)

_____ K-1 _____ 2-3 _____ 4-5 _____ 6-8 _____ 9-12

_____ Special Education Science K-5 (See rule #3)

 _____Special Education Science 6-8 (See rule #3)

_____ Special Education Science 9-12 (See rule #3)

Check all lines that apply to your display:

_____ Display will be standing on table (See rules for size limitations).

_____ Display will require electrical plug-in (110 volts AC)..

_____ Display will be free standing on the floor.

_____ Display will be a poster

Please list your display’s approximate depth, width, and height in feet _______ x _______ x _______

I would like to have a log book sent to me: _____ yes _____ no

I/We agree to follow the Rules and Safety Regulations of the FASF (Fort Atkinson Science Fair).

____________________________________________________________________________________________

(Participant’s Signature)

I/We have read and discussed the FASF Rules and Safety Regulations with my/our child. My/our child has permission

to participate in this science fair.

____________________________________________________________________________________________

(Parent/Guardian Signature/s)