International Rules: Guidelines for Science and Engineering Fairs 2020–2021, Page 35
Regulated Research Institutional/Industrial Setting Form (1C)
This form must be completed AFTER experimentation by the adult supervising the student research conducted
in a regulated research institution, industrial setting or any work site other than home, school or ield.
To be completed by the Supervising Adult in the Setting (NOT the Student(s)) after experimentation:
(Responses must be on the form as it is required to be displayed at student’s project booth; please do not print double-
The student(s) conducted research at my work site:
1. Did you or your proxy (e.g. graduate student, postdoc, employee) mentor or provide
substantial guidance to the student researcher? Yes No
a. If no, describe your and/or your institution’s role with the student researcher and
his/her project (e.g. supervised use of equipment on site without ongoing mentorship
and sign below.
b. If yes, complete questions 2 –5.
2. Is the student’s research project a subset of your ongoing research or work? Yes No
Use questions 3, 4 and 5 to detail how the student’s project was similar and/or
dierent from ongoing research or work at your site. If this project is under a grant and needs
to be acknowledged, please list the grant statement here.
3. Describe the independence and creativity with which the student:
a. developed the hypotheses or engineering goals for the research project
b. designed the methodology for his/her research project
c. analyzed and interpreted data
Student’s Name(s)
Title of Project
Page 36 International Rules: Guidelines for Science and Engineering Fairs 2020–2021,
I attest that the student has conducted the work as indicated above and that any required review and approval
by institutional regulatory board (IRB/IACUC/IBC) has been obtained. Copies are attached if applicable. I further
acknowledge that the student will be presenting this work publicly in competition and I have communicated with
the student research regarding any requirements for my review and/or restrictions of what is publicized.
Supervising Adult’s Printed Name Signature Title
Date Signed (must be after experimenta-tion) (mm/dd/yy)
Address Email/Phone
Regulated Research Institutional/Industrial Setting Form (1C)
Student’s Name(s)
(Continued on next page)
4. Detail the student’s role in conducting the research (e.g. data collection, speciic procedures
performed). Dierentiate what the student observed and what the student actually did.
5. Did the student(s) work on the project as part of a group? Yes No
If yes, how many individuals were in the group and who were they (e.g. high school
students, graduate students, faculty, professional researchers)?
click to sign
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