CALVERT AWARD
Application/Nomination Form
Name of Candidate ................................................... Date
.................................................
Address ....................................................................
Phone No. ........................................
......................................................................
School .....................................................................
Grade ...............................................
Address ...................................................................
Teacher/Sponsor ...............................
.......................................................................
Phone No. ........................................
Project Title ........................................................................................................................
Project Description:
(Continue on the back or attach separate pages as needed.)
Where and when can the project be viewed? .................................................................................
.....................................................................................................................................................
Mail to: Education Committee, Calvert Award, THE AMERICAN ENTOMOLOGICAL SOCIETY,
At The Academy of Natural Sciences of Philadelphia, 1900 Benjamin Franklin Parkway, Philadelphia, PA 19103-1195
Form No. CP121087