intel student

Last Name

Intel STS 2015
Application

First Name

Date of Birth

Project #

Category

Human Subjects: ________ Vertebrate Animals: _________
Human Tissue: __________ Animal Tissue: ______________

Student Information:
Last Name

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Project Title:

Full First Name

City

Full Middle Name

State

Alternate/Nickname

Country

Gender

Parent(s)/Guardian(s): _____________________________________ ______________________________________
High School Information:

High School Name: _________________________________________________________________________________
City: _______________________________ State: ________________
Current Coursework

Country: ____________________________

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In what classes are you currently enrolled?

_________________________________ _________________________________ _____________________________

_________________________________ _________________________________ _____________________________
Student Interests

What subjects in high school have you liked most?

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What do you plan to study in post-secondary education and what occupation do you plan to pursue? What do you hope to be doing 10 years from now?

Intel Science Talent Search 2015

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Last Name

First Name

Project #

Extracurricular Activities
Have you participated in any of the following?
_______ Science fair at the local or regional level
_______ Intel International Science and Engineering Fair (Intel ISEF) finalist

Awards: __________________________________________________________________________________

_______ Broadcom MASTERS

_______ Science training program or summer institute:
__________________________________________________________________________________________

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_______ Other science competition(s):

__________________________________________________________________________________________

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Please list the top 5