CPCUG SCIENCE FAIR JUDGES REPORTING FORM

======================================================================== CPCUG SCIENCE FAIR JUDGES REPORTING FORM: ======================================================================== ======================================================================== EVENT: ======================================================================== COUNTY: ______________________________________ NAME OF EVENT: ______________________________________ ______________________________________ ______________________________________ LOCATION: ______________________________________ DATE(S): ______________________________________ ======================================================================== AWARDEE #1: ======================================================================== PROJECT TITLE: ______________________________________ ______________________________________ STUDENT NAME: ______________________________________ STUDENT ADDRESS: ______________________________________ ______________________________________ STUDENT EMAIL ADDRESS: ______________________________________ STUDENT SOCIAL SECURITY NUMBER: ______________________________________ PARENT/GUARDIAN NAME: ______________________________________ PARENT/GUARDIAN ADDRESS: ______________________________________ ______________________________________ ======================================================================== AWARDEE #2: ======================================================================== PROJECT TITLE: ______________________________________ ______________________________________ STUDENT NAME: ______________________________________ STUDENT ADDRESS: ______________________________________ ______________________________________ STUDENT EMAIL ADDRESS: ______________________________________ STUDENT SOCIAL SECURITY NUMBER: ______________________________________ PARENT/GUARDIAN NAME: ______________________________________ PARENT/GUARDIAN ADDRESS: ______________________________________ ______________________________________ ======================================================================== When complete for both awardees please email to the CPCUG Science Fair Coordinator "Walt Houser" If SSN is not provided or available, we will award a check for $25. ======================================================================== ------- clip above this line ----------------------------------------- Please print out the following and give to the awardees so they will know what's what since we will not have the awards to present at the awards ceremony the weekend of the fair. ------- clip below this line ----------------------------------------- ======================================================================== You have been selected as a recipient of an award from the Capital PC User Group (CPCUG) for "outstanding accomplishment in the understanding or application of computer and telecommunications technology." Each awardee will receive a $50 savings bond (or $25 check), a certificate or plaque, and one year free full membership to CPCUG. You will be contacted about the details of the award presentation. In the meantime you can check out CPCUG at their web site at http://www.cpcug.org/user/scifair/ . ========================================================================

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