Calumet Regional Science Fair & Associated Art Exhibit
Application for a Mentor

I would like to apply for a mentor to help me(or my student) with my(his/her) Science Fair Project.

Name: ____________________________________________________

Address: __________________________________________________

Phone: _______________ e-mail address: ________________________

School: ____________________________________________________

School phone: _________________ fax: _________________________

e-mail: _____________________________________________________________

Grade: ____________________ Teacher: _________________________

Project category: _____________________________________________

Do you need someone to:  ___________ just answer a few questions on the subject

or ______________ help you for an extended period of time?

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