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How to
Register a student project
Form a local SRC/IRB committee
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Students Only!

Regional Registration Form A

This completed form is required for ALL projects.

Due 1/15/10

Please send a nonrefundable $20 registration fee for each participant. If the student lives outside the greater Capital Region (please see the rules for a list of counties), the fee is $30. Make checks out to: STANYS Science Congress.

You also need to send in a paper copy of this form. As with ALL forms the student should keep copies on file in case they are needed.

Send all checks and forms to: Mr. Len Behr: 36 Swiss Farms Road, Hudson, NY 12534



Student's Name
Student's Date of Birth
Student's Grade
Student's Social Security Number
(cash prizes cannot be awarded without a SSN)
Is student a US Citizen?

Student's Home Address
Student's Home Telephone Number
Student's E-Mail
Number of years competing in this fair (including this year)
Project Category (select one)
















Is this a team project?

Team Project Leader
Other Team Member(s)
Project Title
Does your project require prior SRC/IRB approval?

Name of School District
Name of School Building (if different)
School Address & Phone Number
School Principal
Sponsoring Teacher's Name
Teacher's Home Address
Teacher's Home Phone Number
By checking this box, you are creating an electronic signature.
Teacher's Subject Area
Teacher's E-Mail
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