GCS$Elementary$Project$and$Research$Plan$Approval$Form$2014?15$ $ $ GCS$uses$the$Rules$and$Regulations$of$the$North$Carolina$Science$Engineering$Fair$(NCSEF)$and$International$Science$and$ Engineering$Fair$(ISEF)$$$$$$$$http://ncsciencefair.org/$$$$See$Page$2$for$directions.$ Please$print$or$type$information$ Student$Name$____________________________________________________$ Grade__________$ $ Project$Title$_________________________________________________________________________________$ $ Team$project:$$ Yes_____$ No_____$ Team$member(s)$name(s)$1.____________________________________$$$2.$___________________________________$ $ Teacher$Name$______________________________________$ $ School$_______________________________________________$ Where$will$the$experimentation$be$conducted$be$done?$(check$all$that$apply)$$ School$____$ Home$____$ Field$___$ Institution/$work$site$___$(Form$$1C$required)$ $ Research(Plan$$ attached:$$Yes___$$$ Adult$Sponsor:$(check)$Parent$____$ Teacher$____$ Other$______$(Form$1$required)$$ An$adult$sponsor$is$knowledgeable$about$science,$safety$issues$and$regulations.$ $ Qualified$Scientist$(if$required):$Name$____________________________________________________$$$ email____________________$$ phone____________________$ A$qualified$scientist$is$required$if$other$forms$or$prior$approval$from$committees$are$required.$They$should$hold$a$ professional$degree$in$the$student’s$area$of$research.$(See$#4$in$the$directions)$$$ $ Additional(Forms$attached$(names$or$number):$ __________________________________________________________________________________________________$$ $ $ $ $ $ Approvals:$$ Student:$$ I$understand$the$risks$and$possible$dangers$to$me$of$the$proposed$research$plan.$I$have$read$the$GCS$Rules$and$ regulations.$This$is$not$a$continuation/progression$from$a$previous$year.$$I$promise$that$all$research$is$my$own.$$ ________________________$ $ ________________________$ $ ________________________$$$$ $ $ Student’s$Printed$Name$$ $ Signature$$ $ $ $ Date$ (Must$be$prior$to$experimentation)$ Parent/Guardian:$$ I$have$read$and$understand$the$risks$and$possible$dangers$involved$in$the$Research$Plan.$I$consent$to$my$child$ participating$in$this$research.$I$am$the$adult$sponsor$unless$otherwise$noted.$$ ________________________$ $ ________________________$ $ ________________________$ Parent/Guardian’s$Printer$name$$ Signature$$$$$$$$$$$ $ $ $ Date$ (Must$be$prior$to$experimentation)$ Teacher$Approval:$ I$have$approved$the$student$research$plan.$I$determined$if$any$other$forms$or$prior$approval$from$committees$(SRC,$IRB,$ IACUC$or$IBC)$are$required.$If$so,$they$are$attached.$$ ________________________$ $ ________________________$ $ ________________________$$$$ $ $ Teacher$Printed$Name$$ $ $ Signature$$ $ $ $ Date$ (Must$be$prior$to$experimentation)$ GCS$$$$10/20/2014$ $