The 2nd Science Illustration Contest Application Form

Название	The 2nd Science Illustration Contest Application Form
Дата конвертации	19.01.2013
Размер	21.71 Kb.
Тип	Документы
источник

The 2^nd Science Illustration Contest

Application Form

* Use another sheet for additional team member.

Given name Family name			Birth year
Institute
Phone
E-mail
Address	City State/Prov. Country ZIP
Entry Category	□ Illustration			□ Info-graphic
Participants	□ Adult	□ Professional		□ University(Graduate school)
		□ Individual		□ Team
	□ Student	□ Secondary school		□ Elementary school
		□ Individual		□ Team
Topic	□ General
	□ Special	□ The implementation of the smart grid technology in the future □ Chemistry-our life, our future
Title of work
Description
Channel Participant	□ Internet □ Contest Website □ Magazine □ School □ By acquaintance □ Others( )

By submitting this application to The 2^nd Science Illustration Contest, I warrant that this entry is original and has been independently developed and does not violate the copyright.

Your signature: Date:

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