Judge Information Form

Kern County Science Foundation

Judge Information Form

Title: (Mr.,Ms.,Dr.,Military Rank)

First Name:

Last Name:

Institution/Affiliation:

Occupation/job description:

Address:

City:

Zip Code
Email:

Home Phone:
Work Phone:

We will place you on a judging panel as needed. If you have particular expertise or a preference for a certain category, please list it here and we will do our best to honor it.

Previously Judged

Name of other interested persons we should contact:

Name: Phone: or Email:

Name: Phone: or Email:

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