Indiana Science Olympiad 2009 Registration & Membership Form

Please complete one form per team; copies DUE: Monday October 27th, 2008
If your school is sending multiple teams to the tournament, please label your teams "Team A," "Team B," and so on as needed to differentiate between each team you are sending.

SCHOOL DATA

School Name

Phone Number

County

Street Address

City

Zip Code

Name of individual or corporation issuing registration payment:

Division (choose one)
B-Middle School/Jr. High
C-High School

Did this team compete in the 2008 Indiana Science Olympiad Yes No

Is the school registering more that one team in the division indicated above? Yes No

HEAD COACH DATA

(Please list one team contact person)

Name

Home Phone

Home Address

City

State

Zip

E-mail address to be used for Science Olympiad business

Number of years as a coach:

Additional Coaches:

Regional closest to your school (please note that this may NOT be the regional you are assigned to; schools are generally assigned to the regional they attended in the previous year, but if a regional is full or if a school has two or more teams competing, you may be assigned to a different regional site):

Tentative sites and dates

Butler University (Indianapolis) , Feb. 28
Goshen College (Goshen) , Feb. 14
Indiana University Northwest (Gary), Feb. 28
Indiana University Southeast , Feb. 14
Purdue University Calumet (Hammond) , Feb. 28
Indiana University-Purdue University Fort Wayne (C Division only!), Feb. 7
Purdue University West Lafayette , Feb. 21
St. Joseph's College (Rensselear) , Feb. 14
Vincennes University (Vincennes) , TBA

Indiana University - Purdue University Indianapolis (IUPUI) will hold the state tournament on March 25, 2009

MEMBERSHIP FEES

The basic fee for membership and participation in ISO is $225 this year.

Reduced Registration Fee ($125), one time only, for one team from a new school that has not competed in the last 5 years.

An additional $100 fee will be applied if a team advances to state.

Total Membership Fees Due:
(Add super late fee of $100 if sent after Nov 30th)

Complimentary coaches manual: no charge (Add $50 late fee if sent after October 27th)

Make check payable to INDIANA SCIENCE OLYMPIAD

DO NOT include the additional State Tournament fees with this submission!  You will be billed separately for this when your team advances to State.

When you click Submit below, this completed form will be automatically E-mailed to the Indiana Science Olympiad Membership Director at Purdue Calumet, at: scienceolympiad@calumet.purdue.edu

Please send appropriate fees to:

Ms. Gretchen S. Wolf
Department of Chemistry and Physics
Purdue University Calumet
2200 169th St. Hammond, IN 46323-2094
Phone: 219-989-2282
Fax: 219-989-2130