Name

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Middle Name:
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Address

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Address 2:
Address 3:
City:    State:   Postal Code:

Contact Information

Home Phone:    Work Phone:
Fax #:

E-mail:

Professional Information

Employer:
Job Title:
Years Professional Experience:    

Educational Information

Highest Degree:
Degree From:

Judging Background and Preferences

Previous Judging Experience:

Please select two(2) Judging Categories below:

1st Choice: Natural Science ---------------------------------------------------- Physical Science ---------------------------------------------------- Botany ---------------------------------------------------- Chemistry ---------------------------------------------------- Earth & Space Sciences ---------------------------------------------------- Engineering ---------------------------------------------------- Mathematics & Computers ---------------------------------------------------- Medicine & Health ---------------------------------------------------- Physics ---------------------------------------------------- Zoology

2nd Choice: None Natural Science ---------------------------------------------------- Physical Science ---------------------------------------------------- Botany ---------------------------------------------------- Chemistry ---------------------------------------------------- Earth & Space Sciences ---------------------------------------------------- Engineering ---------------------------------------------------- Mathematics & Computers ---------------------------------------------------- Medicine & Health ---------------------------------------------------- Physics ---------------------------------------------------- Zoology

Primary Area of Expertise:

Comments:

I hereby acknowledge that by submitting this application, I agree to serve as a judge for the 2004 Reading Berks Science and Engineering Fair. I also agree to conduct myself ethically and responsibly at all times during the fair. 

 I agree to notify the RBSEF Committee immediately if I become aware of any circumstance, including personal familiarity with an RBSEF participant, that would potentially compromise my ability to evaluate any projects without bias or prejudice.

After review of your application you will be contacted by a RBSEF member to discuss your application.