Calumet Regional Science Fair & Associated Art Exhibit
Mentor Application

Yes, I would like to help the Calumet Region's youth by becoming a mentor!

Name: ______________________________________________________

Address: ____________________________________________________

Phone: ______________________ fax: ____________________________

e-mail: ______________________________________________________

Category Area(s): _____________________________________________

School or Industry affiliation: _____________________________________

I would be available to: _________ answer the occasional question in the area(s),

__________ work with someone long term in an ongoing investigation, or

___________ both

mail to: Calumet Regional Science Fair
              c/o Chemistry Department
              Indiana University Northwest
              3400 Broadway
              Gary, IN 46408

or fax to: (219) 980-6637
or e-mail to lwoz@iun.edu