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SCHOOL SCIENCE CLUB INFORMATION FORM

Science club name *

Ageny *

Quintile 1
Quintile 2
Quintile 3
Quintile 4
Quintile 5
Contact number

School District *

Teacher’s E-mail address *

General Information

School Name:

School Tel No:

Club champion (Teacher/Supervisor):

Champion Tel No:



DECLARATION :

I hereby confirm that I am the educator responsible for the team that will represent our school in the 2021 SAASTA National Schools Debates Competition, and that all the information provided is correct. I also agree to abide by the rules and conditions of the SAASTA National Schools Debates Competition

*

SCIENCE CLUB COMMITTEE MEMBERS:

Chairperson

Name & Surname

Grade

*Race (A, I, C, W)


African


Indian


Coloured


White
**Sex (M/F)

Male

Female

I choose not to disclose

Deputy Chairperson

Name & Surname

Grade

*Race (A, I, C, W)


African


Indian


Coloured


White
**Sex (M/F)

Male

Female

I choose not to disclose

Secretary General

Name & Surname

Grade

*Race (A, I, C, W)


African


Indian


Coloured


White
**Sex (M/F)

Male

Female

I choose not to disclose

Project Coordinator

Name & Surname

Grade

*Race (A, I, C, W)


African


Indian


Coloured


White
**Sex (M/F)

Male

Female

I choose not to disclose

Ranking from most important (1) to least interest (10) – (please enter number 1 to 10 only once indicating your order of preference)

Fun with Mathematics


1


2


3


4


5


6


7


8


9


10
Robotics /Coding / App development


1


2


3


4


5


6


7


8


9


10
Environmental / Green


1


2


3


4


5


6


7


8


9


10
STEM experiments *


1


2


3


4


5


6


7


8


9


10
Debates / Quiz competitions


1


2


3


4


5


6


7


8


9


10
Astronomy / Space Science


1


2


3


4


5


6


7


8


9


10
Olympiads and competitions


1


2


3


4


5


6


7


8


9


10
Building Models


1


2


3


4


5


6


7


8


9


10
Reading / Magazines / Posters


1


2


3


4


5


6


7


8


9


10
Please tick any activities your school is/were involved in :


Eskom Expo


Food Gardens


GLOBE


Maths Olympiads


Science Olympiads


Debates
Any other activities. Please list: