The Western Kentucky Physics Olympics:  Online Registration Form

Please complete the online registration form below.  Required fields are indicated with an asterisk.  If you have any problems using this online form please contact Dr. Doug Harper at 270-745-6194.

There is no registration fee for participation in the Western Kentucky Physics Olympics.  However, to complete the registration process we require:

  1. a current photo of the coach and each team member, and
  2. a completed photo release form for each team member.

These materials can be electronic files (jpg, png, or gif files for the images) e-mailed to or hardcopies snail-mailed to:

Physics Olympics
c/o Dr. Jasminka Terzic
Department of Physics and Astronomy
Western Kentucky University
1906 College Heights Blvd., #11077
Bowling Green, KY 42101-1077

Please complete the following ...

School Information

School Name: *  
Coach's Name: *  
Address: School address will be used to mail contest materials to team.
City                               State     Zip Code
Local Newspaper
Coach's eMail: * Newspaper:  

Coach's eMail will be used to send Registration Confirmation

Coach's Phone: Address:  
Principal's Name:  

Team Name: *  


Team Member 2

Name: * Name: *
Address: * Address: *  
City                               State     Zip Code
City                               State     Zip Code
e Mail: * eMail: *
Phone:   Class:  * Phone:   Class:  *

Team Member 3

Team Member 4

Name: * Name: *
Address: *   Address: *  
City                          State    Zip Code
City                               State    Zip Code
eMail: * eMail: *
Phone:   Class:  * Phone:   Class:  *


Please type the word above to prove you are human: *


* indicates a required field