Idaho Science & Engineering Fair - Judge Registration Question Title * 1. First Name: Question Title * 2. Last Name: Question Title * 3. Name, as you wish for it to appear on Judge Badge: (example: Ms. Susan Johnson, or Dr. Susan Johnson, or Susan Johnson, PhD) Question Title * 4. Email Address: Question Title * 5. Phone Number: Question Title * 6. Mailing Address: (example: 5555 Applegate Rd. Boise, ID 83705) Question Title * 7. Previous Judging Experience: (if applicable - fair name, category commonly judged, number of years) Question Title * 8. Current or Most Recent Employer & Job Title: Question Title * 9. List College Major(s)/Minor(s) & Degree(s): (example: U. of Idaho, BS, Physics / Mathematics) Question Title * 10. Accommodations Needed? (wheel chair access, etc.) Question Title * 11. Special Awards Judging - I am willing to be assigned to judge a special award that is in my area of expertise, in addition to my category project assignment: Yes No Question Title * 12. Please select the fair in which you would like to participate as a judge: Boise State University: February 18, 2017 The University of Idaho: March 4, 2017 Idaho State University: March 11, 2017 Question Title * 13. Please Select Potential Judging Categories: Life Sciences (includes: Animal Sciences, Biochemistry, Cellular and Molecular Biology, Microbiology, Plant Sciences, Biomedical and Health Sciences, Translational Medical Science) Behavioral and Social Sciences (includes: Animal Sciences, Behavioral and Social Sciences) Energy, Earth Science, and Environmental (includes: Earth and Environmental Sciences, Energy: Chemical, Energy: Physical, Environmental Engineering) Engineering (includes: Biomedical Engineering, Engineering Mechanics, Embedded Systems, Robotics and Intelligent Machines) Mathematics and Computer Science (includes: Mathematics, Systems Software, Computational Biology and Bioinformatics) Physical Sciences (includes: Chemistry, Materials Science, Physics and Astronomy) Question Title * 14. Please check the boxes below to verify the following: I am not a parent of a child presenting in a category which I am signing up to be a judge I am not a teacher or mentor for a child presenting in a category which I am signing up to be a judge I am not a site administrator for a school which has students represented at the fair Question Title * 15. By filling this application you are agreeing to the fair conflict of interest, confidentially and harassment rules & policies. I hereby acknowledge that by submitting this application, I agree to serve as a judge for the 2017 Idaho Science & Engineering Fairs. 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 agree to abide by the fair's policy protecting all participants from harassment and sexual harassment by any 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 the fair's responsibility to investigate such claims. In conclusion, I agree to notify the Fair Director (merrierampy@gmail.com) or Judging Coordinator (bradleyjhoward@aol.com) immediately if I become aware of any circumstance that would potentially compromise my ability to attend the event or evaluate finalists' projects. Judge Name/Signature: Done