Required for ALL Projects
RESEARCH PLAN FOR MIDDLE SCHOOL
(Please type or print neatly)
1. Student's Name
2. School
3. Title of Project
4. Science
Teacher
Grade
Home Phone
5. Is this a continuation from a previous year?
previous project?
6. Where will you complete your lab work?
7. Name, address & phone of work site(s):
Example:
Home
202 State Street
Anywhere, USA
Phone
 Yes  No
If yes, how will this project differ from
 Home  School  Research Institution  Field
Location
Address
Phone
* * * * Attach separate pages (limit 3) on which you have answered 8, 9, 10. * * * *
____ 8. What is the problem, hypothesis, or question you intend to investigate?
____ 9. Describe in detail the method or procedures you intend to use.
____ 10. Bibliography: List three (and only three) major sources (i.e., science journal articles, books from
your library research.
1.
2.
3.
4.
5.
SAFETY/APPROVAL FORM
All students must meet with their teacher for Research Plan approval before beginning experimentation.
Any proposed changes in the research plan after initial approval must be resubmitted for teacher reapproval.
All manufactured safety precautions must be followed when using any chemical. (Read the label!) No
controlled substances may be used. Controlled substances include tobacco and tobacco products,
alcohol, controlled drugs, etc.
No cultures taken from the environment may be grown. Unacceptable are cultures of bacteria taken
from washed and unwashed hands, cutting boards, saliva, or kitchen sponges, soil, water, pets, etc.
(Growth of mold on food items is acceptable.)
Projects dealing with vertebrates, including humans, are to be observational or survey type projects only;
and must have prior approval of the teacher, department chair and Director of Science from Central
Office.
OBSERVATIONAL PROJECTS
Information or data is obtained by observing vertebrates, including humans, in their natural state with no
interaction between the researcher and the vertebrate.
Acceptable examples of such projects include:
 tabulating the number and kinds of birds observed at a bird feeder over a period of time;
 the observation and recording of data related to left-handedness in males/females by observing a public
access door over a period time;
 comparison of the frequency of tree frog chirps with the ambient temperature over a period of time.
Unacceptable observational projects are:
 watching the running of mice through a maze;
 monitoring (observing) heart rates or respiration after exercise;
 "observing" reactions after the administration of a substance;
 treating vertebrates, such as:
 tapping fish tank before feeding fish
 testing vision wearing various colors of glasses
SURVEY PROJECTS
Information or data is obtained by simply interviewing or asking questions of humans without any
treatment being applied. Such interviews or questions must not present any psychological, social, legal, or
other risk or embarrassment to interviewee. Survey questions must be submitted and approved by both
teacher and parents before survey is given. County Administrative Procedures must be followed.
Acceptable examples of survey type projects include:
 simple pencil and paper surveys or opinion surveys;
 perception questions, such as color determination or figure analysis, presented without a before and/or
treatment.
Unacceptable examples of survey type projects include those in which a treatment such as exercise,
ingestion, touching, inhaling, injection, some type of learning, etc. is done after an initial survey, followed
by a post treatment assessment, such as comparing the learning rates of male/females after learning
treatment has been administered.
6.
Display and Safety Regulations must be read and followed.
* * * * * * * * * * REQUIRED FOR ALL PROJECTS * * * * * * * * * *
A. Student Agreement: I will follow the above Guidelines for my Science Fair Project and agree that the
completed project will be my own work.
_____________________________________________________
Student's Signature (print and sign)
___________________________
Date
B. Parent /Guardian Approval: I have read and understand the above Guidelines and will monitor my
child's experiment. I consent to my child participating in this research and affirm that I have only
contributed in a supervisory capacity unless otherwise noted in the procedure.
_____________________________________________________
Parent/Guardian Signature (print and sign)
___________________________
Date
C. Teacher Approval: I have approved the Research Plan prior to experimentation and reviewed the
Safety Regulations with the student.
_____________________________________________________
Teacher 's Signature (print and sign)
___________________________
Date
*D. Director of Science Approval:
____________________________________________
________________
Signature

Approved

Not Approved
Date
*Director’s approval only required for projects involving any vertebrate (including humans and
surveys). These projects must be pre-approved by December 1, 2011 for registration into the Charles
County Science Fair.
Middle School
Checklist for Adult Sponsor/Safety Assessment Form (1B)
This completed form is required for ALL projects and
must be completed prior to experimentation
Student’s Name:
1.

2.

3.

The student and a parent/guardian have signed the Research Plan for Middle
School.
I, (Adult Sponsor), have reviewed the Research Plan, Research Plan
Attachment and signed Approval Form (1B).
This project involves the following area(s) and requires approval before
experimentation begins:
 Human Subjects


4.
Non-Human Vertebrate Animals
DNA

This project involves the hazardous substances or devices checked below. An
Adult Sponsor/A Designated Supervisor will provide proper supervision to the
student. Prior approval by the adult sponsor and certification by a designated
supervisor is required.
 Chemicals (i.e., hazardous, flammable, explosive or highly toxic; carcinogens;
mutagens and all pesticides). I have reviewed with the student the material Safety Data
Sheet (MSDS) Listing for each chemical that will be used. I have also reviewed the
proper safety standards for each chemical including toxicity data, proper handling
techniques, and disposal methods. For Safety in Academic Chemistry Laboratories, write
to the American Chemical Society, Career Publications, 1155 16th St., NW, Washington,
DC (202/872-4512).
 Equipment (i.e., welders; lasers; voltage greater than 220 volts). I have reviewed
with the student the proper operational procedures and safety precautions for the
equipment to be used by the student. For information about laser standards and research,
write to the Food and Drug Administration, Office of Compliance, 2098 Gaither Road,
Rockville, MD 20850 (301) 594-4692).
 Fire. I have reviewed with the student the proper safety precautions and will directly
supervise the student use of fire or flames.
 Firearms. I have reviewed with the student the proper safety standards for firearms
use.
 Radioactive Substances. I have reviewed the proper safety standards for each
radioactive substance the student will use.
 Radiation (i.e., x-ray or nuclear; unshielded ionizing radiation of 100-400 mm
wavelength). I have reviewed with the student the proper safety methods concerning the
type of radiation the student will use.
5.

This project does not involve any of the research areas listed in #3 or #4.
Adult Sponsor/Designated
Supervisor Printed Name
Signature
Date of Review