Qualified Scientist Form for Science and Engineering Fairs 2026–2027

This form is required for projects requiring a Qualified Scientist or Direct Supervisor. This form must be completed by the Qualified Scientist before experimentation.

To be completed by the Direct Supervisor

When the Qualified Scientist cannot directly supervise:

I certify that I have reviewed the Research Plan/Project Addendum and have been trained in the techniques to be used by this student, and I will provide direct supervision.

Direct Supervisor’s Printed Name	Experience/Training of Direct Supervisor	Signature	Date of Approval (mm/dd/yy)	Phone	Email

To be completed by the Qualified Scientist

I certify that I have reviewed and approved the Research Plan/Project Addendum prior to the start of the experimentation. If the student or Direct Supervisor is not trained in the necessary procedures, I will ensure their training. I will provide advice and supervision during the research. I have a working knowledge of the techniques to be used by the student in the Research Plan/Project Addendum.

Qualified Scientist’s Printed Name	Signature	Date of Approval (mm/dd/yy)	Student’s Name(s)	Title of Project

To be completed by the Qualified Scientist

Scientist Name:

Educational Background: Degree(s):

Experience/Training as relates to the student’s area of research:

Position/Institution: Email/Phone:

Project Involvement

1. Please indicate what the student project will involve:
   • Human participants:
     Yes
     No
   • Animals:
     Yes
     No
   • Potentially hazardous biological agents (microorganisms, rDNA and tissues, including blood and blood products):
     Yes
     No
   • Hazardous substances and devices:
     Yes
     No
2. Will this study be a sub-set of a larger study?
   Yes
   No
3. Will you directly supervise the student?
   Yes
   No
4. Please describe your anticipated role in this project and the duration of your support.
5. Will you provide any data; if yes, please provide source or describe:
   Yes
   No