2023 PARTICIPATION RESPONSE FORM U.S. NATIONAL CHEMISTRY OLYMPIAD

COMPLETE ASAP

Local Section ID and Name *

Please check all that apply *

Yes, we will participate in the 2023 USNCO program.

Yes, I am a new USNCO Coordinator

First name *

Last name *

Mailing Street Address *

Address Line 2

City *

State *

Zip Code (enter 00000 if international) *

E-mail *

Work Phone *

Cell Phone *

List other Local Section volunteers and persons involved in the USNCO program *

Do you have any suggested topics for future USNCO webinars? *

When agreeing to serve as a Chemistry Olympiad coordinator, you are required to disclose any perceived or real conflicts of interests to the USNCO Subgroup of the ACS Society Committee on Education. Having a paid tutoring arrangement for the Chemistry Olympiad creates a real conflict of interest disqualifying your involvement from coordinating, administering, or preparing the Chemistry Olympiad exams. *

I confirm that I do not have a conflict of interest.

Are you or your colleagues interested in serving as a member of a USNCO task force or the governing subgroup? Read more about these opportunities and share your interest here.

Please sign electronically *

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