BioScience Montana August 2015‐ March 2016 TEAM APPLICATION
Application Deadline: May 1, 2015
Return to: Stephanie Davison via mail, fax, or email
Mail: 210 Taylor Hall, Bozeman MT 59717. Fax: 406-994-5417 Email: [email protected]
Instructions: Teams interested in participating in BioScience Montana must complete this
application in its entirety and return by May 1, 2015.
 Applications must include complete information for the leader and each participant (a
maximum of four participants going into 8th grade -11th is allowed per team).
 Each team member and leader must have the ability to do the following: Acquire an
email address to be used specifically for this project, use a social media program
such as Google+ and abide by all Internet safety precautions that will be provided,
travel to the MSU Bozeman campus twice, meet with their team on a regular basis
to complete module work, and attend virtual lab meetings held via Google hangout.
 Campus Visit Dates: Aug. 3-7 (begins Monday afternoon, wraps up Friday after lunch)
and a mid-winter or early spring science weekend get together. Travel stipends are
available, food and lodging when in Bozeman is paid with project funds.
 All team members must be 4-H members; if you are not already a member, please contact
your county MSU Extension Office. All team leaders must be certified 4-H leaders, if
you are not already a leader, please contact your county MSU Extension Office.
Name: LEADER INFORMATION
Are you a certified 4‐H leader? Address: City/State/Zip: Phone(s): Email: As a leader, what experiences have you had with youth projects? What was the leading strength you provided to the youth in these projects? What do you expect to gain from the BioScience experience? Why is your team uniquely qualified to be a part of BioScience Montana? Collectively, what experiences in science and related subjects has your group been involved with inside/outside of school? Name: Email (personal): Age and date of birth: Email (parent): Address: City/State/Zip: Years of 4‐H membership: Phone (yours): Phone (parents): Why are you a good candidate for BioScience Montana? What do you hope to get out of this program? How has science impacted your life? Why is your leader a good choice to serve as a coach and coordinator? How often do you use email? Do you have any experience with online discussions, forums, or communities? If so, which ones have you used? Name: Age and date of birth: Address: City/State/Zip: Phone (yours): Email (personal): Email (parent): Years of 4‐H membership: Phone (parents): Why are you a good candidate for BioScience Montana? What do you hope to get out of this program? How has science impacted your life? Why is your leader a good choice to serve as a coach and coordinator? How often do you use email? Do you have any experience with online discussions, forums, or communities? If so, which ones have you used? Name: Age and date of birth: Address: City/State/Zip: Phone (yours): Email (personal): Email (parent): Years of 4‐H membership: Phone (parents): Why are you a good candidate for BioScience Montana? What do you hope to get out of this program? How has science impacted your life? Why is your leader a good choice to serve as a coach and coordinator? How often do you use email? Do you have any experience with online discussions, forums, or communities? If so, which ones have you used? Name: Age and date of birth: Address: City/State/Zip: Phone (yours): Email (personal): Email (parent): Years of 4‐H membership: Phone (parents): Why are you a good candidate for BioScience Montana? What do you hope to get out of this program? How has science impacted your life? Why is your leader a good choice to serve as a coach and coordinator? How often do you use email? Do you have any experience with online discussions, forums, or communities? If so, which ones have you used?