GREATER SAN DIEGO SCIENCE & ENGINEERING FAIR (GSDSEF) PROJECT PROPOSAL/SIGNATURE* FORM (GSDSEF-1, 2012)
T h i s form must be completed and signed prior to starting project work. It mu st b e placed in the student’s notebook with an ABSTRACT OF THE PROJECT for the GSD SEF Screening Fair. 1. Project Title ______________

Is this a continuation of a previous project?

 Yes

 No

2. STUDENT'S NAME (Last, First, Middle)_______________________________________________________ 2a. Partner’s Name (for Senior Division 2 person projects only) 3. Address, City, Zip 4. Phone 5. School email _____Grade
_________________ EACH SENIOR DIVISION PARTNER MUST SUBMIT A SEPARATE PROJECT PROPOSAL FORM.

_______ ______________ ______________

6. Teacher_______________________________________________________________________________________________________ 7. This project involves (check all that apply):  Live Vertebrate Animals (GSDSEF-2, 2012)  Humans as subjects, helpers, or interviewees (GSDSEF-3, 2012)  Hazardous Substances (anything that could cause injury) (GSDSEF-4, 2012)  Chemicals  Infectious Agents  Bacteria, Fungi and/or Molds Mutagenic Agents  Carcinogenic Agents  Teratogenic Agents  Human or Other Vertebrate Tissue (GSDSEF-5, 2012)
8. WHERE

REQUIRED (see #7 above), the following supplemental forms must be completed and included with the project proposal form (CHECK ALL THAT APPLY): ______Certification of Humane Treatment of Live Vertebrate Animals (GSDSEF-2, 2012) ______Certification of Compliance of Research Involving Humans (GSDSEF-3, 2012) ______Certification of Hazards Control (GSDSEF-4, 2012) ______Certification of Vertebrate Tissue Source & Safety (GSDSEF-5, 2012)

9. Location where experimental procedures will take place:____________________________________
_____________________________________________________________________________________________________________________

10. People, companies, etc. providing equipment, materials, workspace:________________________________
_____________________________________________________________________________________________________________________

11. Describe, in 200 – 250 words, the planned project/experiment and the procedures to b e used:
_____________________________________________________________________________________________________________________ ________________________________________________________________________________________________________(attach a page)

Just before the screening fair, attach a 200-250 word ABSTRACT of your project to this form.

*Continue to next page for required Signatures

Page 2 – Project Proposal/Signature Form (GSDSEF-1, 2012)

GREATER SAN DIEGO SCIENCE & ENGINEERING FAIR (GSDSEF)
PROJECT PROPOSAL/SIGNATURE FORM (GSDSEF-1, 2012)

REQUIRED SIGNATURES:
Student:
I have read the Rules and Regulations of the GREATER SAN DIEGO SCIENCE AND ENGINEERING FAIR and certify that my project complies with them. I understand that failure to meet the terms of these rules and regulations will result in the disqualification of my project.
SENIOR DIVISION: GSDSEF forms meet the requirements of California law; therefore, all S e n i o r D i v i s i o n students agree that, should they be selected to compete at the 2012 Intel International Science and Engineering Fair (Intel ISEF), when they sign all required Intel ISEF forms they will predate them to agree with the date on this form.

____________________________________________________________________________________ Student Signature/Date

Parent/Guardian:
I am aware of all potential safety hazards connected with this project, approve the precautions being taken to ensure my student’s safety and will, when appropriate, provide guidance and/or supervision. I understand that failure to comply with the Rules And Regulations of the GREATER SAN DIEGO SCIENCE AND ENGINEERING FAIR will result in the disqualification of the project. _____________________________________________________________________________________ Parent Signature/Date

Teacher:
I approved this project prior to the student beginning work on it and verified that it complies with the Rules And Regulations of the GREATER SAN DIEGO SCIENCE AND ENGINEERING FAIR. Any concerns about the project’s design, appropriateness, safety, or legality were submitted to the GSDSEF Scientific Review Committee (SRC) at src@gsdsef.org for approval prior to allowing the student to proceed. I understand that failure to comply with the Fair’s Rules And Regulations will result in the disqualification of the project. I will provide all needed supervision (other than that specified on other included forms) and will ensure that this proposal and all required supplemental forms are included in the student’s notebook at t h e screening fair. I will have the student, i f i n v i t e d to apply for entrance to the GSDSEF, submit all SRC requested certification forms with their 2012 Application for Entrance. _____________________________________________________________________________________ Teacher Signature/Date

Additional Advisor (if required)
When certification forms ( GSDSEF 2, 3, 4 or 5, 2012) are signed by someone in addition to the science teacher, a signature here ensures that the procedures described on these forms will be followed. ___________________________________________________________________________________ Additional Advisor Signature/Date