School Data

School:

Phone:

County:

Street Address/City/Zip:

Division: B-Middle School/Jr. High C-High School

Did this team compete in the 2006 Indiana Science Olympiad? Yes No

Head Coach Data

Name:

Contact Number:

Home Address/City/State/Zip:

E-mail:

 Retype E-mail:

Membership Fees

National Science Olympiad Affiliation Fee - $60.00 (required)
Indiana Science Olympiad Registration Fee - $140.00 (required)
Reduced Registration Fee ($100), one time only, for one team from new schools that have not competed in the last 5 years.
NOTE: State Tournament teams will be assessed an additional $50 fee

Make check payable to INDIANA SCIENCE OLYMPIAD
*Add $50 late fee is sent after October 31!
Check should be sent to:

Dr. Kenneth J. Schoon
Schoolof Education
Indiana University Northwest
3400 Broadway
Gary, Indiana 46408
FAX: (219)981-4208

Confirmation will be sent within 3 weeks after receipt of both the completed membership form and the appropriate fees.

NO REFUNDS