Science and Engineering Fair

Student Winner's Name:

Student's Street Address:

City:

State:

ZIP Code:

Student's School Name:

This is submitted by:

Relationship to student:

E-mail address:

Telephone Number:

Student's Grade?
Select one K 1 2 3 4 5 6 7 8

Did the Student submit a Science Fair Project or an Invention?
Select one Science Fair Project Invention

Student Winners are allowed to bring TWO ADULT guests to the Awards Night Dinner.  The two adult guests that the student will bring are:

Adult Name 1:

Adult Name 2:

Questions, Comments, or Concerns:

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