| ____ | Computer Art | ____ | Pastels | ____ | Water Color |
| ____ | Pen & Ink | ____ | Photography | ____ | Ceramics |
| ____ | Oil | ____ | Mixed Media |
Firm or School ___________________________________________________________________
Title or Occupation ________________________________________________________________
Address _________________________________________________________________________
City _________________________________________ State ____________ Zip _____________
E-Mail Address __________________________________________________________________
College Major(s) _________________________________________________________________
Minor(s) ________________________________________________________________________
This is my _________ year to serve as a judge at the Calumet Regional Science Fair & Associated Art Exhibit.
Signature _____________________________________________________________
Application Deadline: February 15, 2002
mail to: Calumet Regional Science Fair
c/o Chemistry Department
Indiana University Northwest
3400 Broadway
Gary, IN 46408
or fax to: (219) 980-6673
or e-mail to lwoz@iun.edu