If you're organizing a local Scientific Review Committee (SRC) or Institutional Review Board (IRB),
print this form (click here to print), fill it in, and send it to:

EISEF Safety and Standards Committee
P.O. Box 10862
Cedar Rapids, Iowa 52410-0862

You should send this form with any student entry that includes a school SRC/IRB signature.

For guidelines on Scientific Review Committees and Institutional Review Boards,
read the SRC/IRB Guidelines (http://www.societyforscience.org/isef/aff_fairs/aff_review.pdf) on the Intel ISEF web site.

SRC/IRB Chair name

 

Field of Study

 

Degrees &/or qualifications

 

Institutional affiliation

 

Complete mailing address

 

 

 

Telephone

day

 

night

 

fax

 
E-mail address  

Member name

 

Field of Study

 

Degrees &/or qualifications

 

Institutional affiliation

 

Complete mailing address

 

 

 

Telephone

day

 

night

 

fax

 
E-mail address  

Member name

 

Field of Study

 

Degrees &/or qualifications

 

Institutional affiliation

 

Complete mailing address

 

 

 

Telephone

day

 

night

 

fax

 
E-mail address  

Member name

 

Field of Study

 

Degrees &/or qualifications

 

Institutional affiliation

 

Complete mailing address

 

 

 

Telephone

day

 

night

 

fax

 
E-mail address  

Member name

 

Field of Study

 

Degrees &/or qualifications

 

Institutional affiliation

 

Complete mailing address

 

 

 

Telephone

day

 

night

 

fax

 
E-mail address  

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