U.S. Agency for International Development (USAID) Science Champion Award for International Science and Engineering Fair (ISEF)-Affiliated Fairs: Winning Project Submission Form 

Office of Management and Budget (OMB) Number: XXXXXX
Expiration Date: XXXXX

Instructions: 
Please fill out the below information as soon as possible after the conclusion of your International Science and Engineering Fair (ISEF)-Affiliated Fair. Email stfellowships@usaid.gov with any questions. 

The information collected in this form will provide accurate accounting of all recipients of the United States Agency for International Development (USAID) Science Champion Award for ISEF-Affiliated Fairs. This data collection will enable USAID staff to issue the invitation to the virtual conversation with USAID to all recipients. Public reporting for this collection of information is estimated to be approximately five minutes per response.

Privacy Notice:
This survey is administered by the USAID Research Division's Fellowships Team, in the Innovation, Technology, and Research (ITR) Hub in the Bureau for Inclusive Growth,  Partnerships, and Innovation (IPI). Completion of this survey is voluntary. You may choose to respond to all or any of the questions. Your participation will help ensure adequate representation in the final results and outcomes. If you agree to participate, you may withdraw your participation in the survey at any time by simply exiting the survey. For more information, please contact stfellowships@usaid.gov. 

As a reminder, please do not include any unsolicited Personally Identifiable Information in response(s).

Paperwork Reduction Act Statement:
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor shall a person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid Office of Management and Budget (OMB) Control Number. The OMB Control Number for this information collection is XXXXXXX. Public reporting for this collection of information is estimated to be approximately five minutes per response.
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Email *
Form Submitter's Name *
Affiliated Fair Number *
For Example: USAL01
Fair Name *
Fair Date(s)  *
MM/DD/YY
Fair Location *
City/State/Country
Fair Director Name *
Fair Director Email Address *
About The Winning Project
Project Name *
Brief Project Description *
1-2 sentences only
Team or Individual Winner? *
Student Name(s) *
Note: If multiple students, please list student names and other information requested below in the same order.
Student Grade Level(s) *
Student School Name(s) *
Student School Location(s) *
Student Email Address(es) *
Student's Advisor Name *
Student's Advisor Email Address *
I have received consent from the parents/guardians of this/these student(s) to collect this information and share it with USAID for the purpose of communicating about the Science Champion Award. *
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