W. I. S. E.  2001

 

Wonders of the Imagination Science Exhibition

 

Media Release

 

Parents:           If you would like W.I.S.E. to notify the media about your child’s award(s), please complete and check the following information, sign and date this authorization form, and return it no later than Saturday, March 24, 2001, to Science Fair Media Release, 7658 Salter Court, Temperance, Michigan 48182.

 

Please print in black or blue ink the items you want included in the media release.

 

Name of Child                                                                                                                                      

 

Name of Award(s)                                                                                                                                 

 

Title of Science Fair Project                                                                                                                  

 

City and State of Residence                                                                                                                  

 

Names of Parents                                                                                                                                 

 

Please check which media you would like to be notified.  Note that W.I.S.E. has no control over whether or not the media will choose to publish or broadcast this news item.

 

            Newspaper – Adrian Telegram

            Newspaper – Ann Arbor News

            Newspaper – Bedford Press

            Newspaper – Bryan Times

            Newspaper – Defiance Crescent-News

            Newspaper – Detroit Free Press

            Newspaper – Detroit News

            Newspaper – Dundee Independent

            Newspaper – Findlay Courier

            Newspaper – Jackson Citizen Patriot

            Newspaper – Monroe Evening News

            Newspaper – Sandusky Register

            Newspaper – Toledo Blade

            Newspaper – Toledo Parent News

            Radio – WGTE

            Radio – WPOS

 

Please sign and date your authorization below.

 

I hereby authorize W.I.S.E. to provide the information included above to the media checked above.

 

Signature of Parent                                                                                Date