Intel ISEF Volunteer Grand Awards Application
 
Intel ISEF

Intel International Science and Engineering Fair 2011
May 8 - 13, 2011 in Los Angeles, California
Judging Dates: May 10 - 11, 2011
Application to Serve as a Volunteer Grand Awards Judge
Submission of this form is a statement of your willingness to serve as a Volunteer Grand Awards Judge at the Intel International Science and Engineering Fair to be held in Los Angeles, California in May, 2011

Society for Science & the Public of Washington, D.C. is the non-profit agency that conducts this international event, and they set the criteria for becoming a judge, which read as follows:

Judges must have a Ph.D., M.D., or equivalent, OR a B.A., B.S. or a masters degree with a minimum of six years related professional experience. Judges may include university faculty, industrial scientists and engineers, representatives of private and federal research centers and agencies, and medical researchers. Affiliated science fair directors, ISEF official party members, individuals traveling to the ISEF with an official party, parents or relatives of a finalist, chaperones, mentors or elementary or secondary teachers may not be eligible to judge.

Judges are expected to be available from Tuesday afternoon May 10 through Wednesday evening May 11, 2011 to complete their judging assignments. Please provide the information requested below if you desire to be a judge. We will contact you, after we receive your application, by e-mail (preferably) or regular mail. Thank you for your participation.

 

Please be sure to submit your complete name, full mailing address, at least one phone number where you can be reached and most important, if available, your e-mail address. You must provide your first choice of category and subcategory (discipline). There is a look up table provided for selecting a category/subcategory pair for both your first and second choices.

Prefix:   First Name:
Middle Name:
Last Name:   Postfix:

NOTE: Please enter address where correspondence can be sent most easily.
Address 1:
Address 2:
Address 3:
City:   In U.S.?   State:
Not in U.S.: Province:   Country:
Please be aware that SSP is unable to financially support or write visa invitation letters letters for Grand Award judges
Postal Code:

Home Phone:   Work Phone:
Fax Phone:   Cell Phone:

E-mail:
Verify E-mail:

Gender: Male;    Female

Age Range (Optional):

Ethnicity (Optional):

Current or Most Recent Employer:

Type of Employer:

Are you Retired? No;    Yes

Job Title:
Years Professional Experience:
Previous Judging Experience:

Primary Category/Subcategory in which you qualify to judge:

Highest Degree Obtained in this Category:
Degree From:
Primary Area of Expertise:

If possible, please identify a second category that you are qualified and willing to judge. We assume if you give us a second category that you will judge in the category if requested. Please do not list a second subcategory within your primary category. Use the default, None, if you would prefer to judge ONLY in your Primary category.

Second Category that you are qualified and willing to judge:

Diet: Normal;    Kosher;    Vegetarian;    Vegan (Strict Vegetarian)

Parking required:No    Yes;

Accommodations Required: No;    Yes
Please note that the Intel ISEF is unable to monetarily support Judges' housing at this time; however, we are interested in knowing how many judges require accommodations so we can insure availability.

When would you plan to arrive and depart from the ISEF city and what mode of transportation would you use?

Arrival Date (mm/dd/yyyy):
Departure Date (mm/dd/yyyy):
Mode of Transportation (auto, plane, etc.):

Are you a member of an ISEF affiliated fair's official party, an individual traveling to the ISEF with an official party, a parent or relative of a finalist, a chaperone, a mentor or an elementary or secondary teacher (Y/N)?   
If you are an official party member or with the official party, please explain below in what capacity:


If you require special assistance (ADA), please indicate below:


I hereby acknowledge that by submitting this application, I agree to serve as a judge for the 2011 Intel International Science and Engineering Fair. I agree to act in a positive and ethical manner in which each student encountered is treated fairly and respectfully. Privileged information or ideas that are obtained through my volunteer service will be kept confidential by me and I will not use such information or ideas nor disclose such information or ideas to third parties. I agree to disclose all conflicts of interest resulting from direct competitive, collaborative or other relationships with any of the students and to recuse myself from judging in such circumstances. I acknowledge that I have read and agree to abide by the Society for Science & the Public's harassment policy protecting all Intel ISEF participants from harassment and sexual harassment by another Intel ISEF participant or other person for any reason including, but not limited to: age, national origin, race, color, religion, gender, sexual orientation, marital status, disability, ancestry and/or veteran status and understand SSP's responsibility to investigate such claims. In conclusion, I agree to notify SSP's Judging Coordinator immediately if I become aware of any circumstance that would potentially compromise my ability to attend the event or evaluate finalists' projects.



Please wait for confirmation page after submission - it can take a while to appear.


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Washington, DC 20036
phone: 202/785-2255
fax: 202/785-1243

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