Scholars' Week Registration Form


Scholars Week April 16-20, 2012	Undergraduate and Graduate Student Registration Form Registration Deadline: March 26, 2012

	The following registration form is used for all Scholars Week activities.
Student Name (contact person)
Major
Class Level	Graduate Student Undergraduate Student Freshman Sophomore Junior Senior
Local Address
Local Tel. #
E-Mail Address
Faculty Sponsor/Mentor
Additional Faculty Sponsor/Mentor
TEAM/GROUP PROJECTS If this is a team or group project, please list the names and class level of ALL additional team members. The student listed above will be the contact person for the group. If contacted by the URSA office, it is the responsibility of this student to make certain that all members of the team receive information regarding the display or presentation of the project. The names of all students participating in the project will be listed on the published abstract. PLEASE BE CERTAIN THAT ALL STUDENT NAMES ARE SPELLED CORRECTLY. If more than six additional students are involved in the project, please email a complete set of names and class levels to the Office of Undergraduate Research and Scholarly Activity (ursa@murraystate.edu).
Student 2 Name
Major
Class Level	Graduate Student Undergraduate Student Freshman Sophomore Junior Senior
Student 3 Name
Major
Class Level	Graduate Student Undergraduate Student Freshman Sophomore Junior Senior
Student 4 Name
Major
Class Level	Graduate Student Undergraduate Student Freshman Sophomore Junior Senior
Student 5 Name
Major
Class Level	Graduate Student Undergraduate Student Freshman Sophomore Junior Senior
Student 6 Name
Major
Class Level	Graduate Student Undergraduate Student Freshman Sophomore Junior Senior
Student 7 Name
Major
Class Level	Graduate Student Undergraduate Student Freshman Sophomore Junior Senior

Does this project involve the use of animals?	Yes No
If animals are involved, have you received Institutional Animal Care and Use Committee (IACUC) approval?	Yes No

Does this project involve the use of human subjects?	Yes No
If humans are involved, have you received Institutional Review Board (IRB) approval?	Yes No

Special Scholars Week Poster Sessions:
If you would like your project entered in one of the following Scholars Week special poster events, please check YES below. If NO is checked, your poster will be scheduled in the general poster session.
Yes No	Sigma Xi Poster Competition (undergraduate and graduate students): As part of Scholars Week, Sigma Xi the scientific honor society, will host a poster competition for undergraduates and graduate students whose projects are in the sciences (biology, chemistry, physics, geosciences, mathematics and statistics) or in other disciplines that utilize the scientific method, such as nursing, psychology, and engineering.
Yes No	Graduate Research Symposium in Education This poster session will feature the work of graduate students in the College of Education who are working on a Master's degree or a Specialist in Education degree, as well as other research in progress.

Project Title:

Abstract / Summary or Description of Work (Limit 250 words):


Presentation Format:
	Poster (Easels will be provided but students must provide their own backing board. Poster size may not exceed 4' X 4'.) Oral Presentation Art Display Painting/Drawing/Photograph Sculpture Performance Other (Describe below)
Presentation, Display or Performance Equipment Requirements:
	(More than one item may be checked.) Overhead *Computer with Projector (for PowerPoint and Other Presentation.) (Formatted for use on PC ONLY.)* Slide Projector Projection Screen VCR Player and TV DVD Player and TV Music Stand Display Pedestal Easel (Students must provide their own backing board.) Other Equipment (List below)
For your records, please PRINT a hard copy of this form before clicking on the Submit button. Be certain to save a complete copy of your abstract, summary or description of your work.

Thank you for submitting a project to Scholars Week. To verify that your registration has been received, we will contact you via email (at the address you have provided above) within one week. If you do not receive this verification email, please contact us at 809-3192. Again, we appreciate your support of the Scholars Week program.
UNDERGRADUATE RESEARCH AND SCHOLARLY ACTIVITY Room 226b Wells Hall Murray State University - Murray, Kentucky 42071 (270) 809-3192

TEAM/GROUP PROJECTS