WaCSEF Student Registration

This form registers the project and the student(s) in the WaCSEF fair. One form for each student or team member. Please see the list of SRC forms that maybe required in addition to this form. This form should be completed, printed out, signed, check attached and mailed to Jim Jaeschke, W276N2666 Lily Court West, Pewaukee, WI 53072

Date:

Student:

First Name:
Middle Name:
Last Name:
Gender:
Grade:
Address1:
Address2:
City:
State:
Zip:
Email:

School:

School Name:
Teacher/School Contact:
Teacher/School Phone:
Teacher/School Email:
Has the school been informed of your project?

Did you participate in Another Fair in the last 12 months?
If yes, Please provide the following information,

Other Fair name:
Date:
Location:

Project:

Project Title:

Select Your Project Category (ID Range):

Engineering (600-699)
Math/Computers (700-799)
Medicine/Health (800-899)
Physics (900-999)

Behavioral/Social Science(000-099)
Biology (300-399)
Chemistry/Biochemistry (400-499)
Environmental (500-599)

Is this a Team Project? Yes Team Member:
Team Member:

Note: Only a total of three students are permitted per team project

Special Notes(Tall project, need Electric, etc)

Fees:

The entrance fee for each student is $15.00. Scholarships are available. Please attach check made out to the Wisconsin Science Education Foundation to this form. If you would like to provide support for the registration of one or more students, please add $15.00 or more to your registration fee.

WaCSEF is made possible by the efforts of 30 volunteers and donations from our sponsors and individuals. We need your support to keep this great event alive. Please consider adding a tax-deductible donation to your registration fee. Thank you very much for your support.

Permissions

Photo use Permission

I grant to Waukesha Colleges Science and Engineering Fair and the Wisconsin Science Education Foundation and assign the nonexclusive right to publish and reproduce photographs taken of me and my project during science fair events sponsored by Waukesha Colleges Science and Engineering Fair and the Badger Sate Science and Engineering fair for promotional and educational purposes for a period of five years.

Signatures:
Student_______________________________________ Date:_______

Parent ________________________________________ Date:_______ PrintName:____________________________________
Relationship to Student:___________________________

Last Steps

Please fill out and print this Form
Sign
Attach Check
Mail to
Jim Jaeschke, W276N2666 Lily Court West, Pewaukee, Wi 53072
UWM-Waukesha Registration
Please download and print this Form
Fill Out UWM-Waukesha Student Health and Release Form
Mail To:UWM-Waukesha Continuing Education
1500 N University Dr
Waukesha, WI 53188