PRIVACY ACT STATEMENT

This form, Registration for Naval Science Awards, and the Assurance of Compliance statement, are authorized by 5 U.S.C. 301. The purpose is to provide data to the Naval Science Awards Program Manager for local, regional, and state science and engineering fairs and to assure compliance with Equal Employment Opportunity. The information provided is used to forward Navy and Marine Corps Science Awards materials to science and engineering fair directors and to establish contact with them on any problem that arises concerning Navy and Marine Corps participation in their fairs. Disclosure of this information is voluntary. Science and engineering fair directors not furnishing name, address, telephone number, location of and dates of fair, and Assurance of Compliance with Civil Rights Act of 1964 will not receive Naval Science Awards materials.

ASSURANCE AND COMPLIANCE WITH THE DEPARTMENT OF DEFENSE DIRECTIVE UNDER TITLE VI OF THE CIVIL RIGHTS ACT OF 1964

(Name of Fair - herinafter called "Applicant") HEREBY AGREES THAT it will comply with the policy of the Naval Science Awards Program not to discriminate against or provide any assistance to any activity which discriminates against any person on account of creed or sex: and with the Title VI of the Civil Rights Act of 1964 (P.L. 88-352) and all requirements imposed by or pursuant to the Directive of the Department of Defense (32 CFR Par 300, issued as Department of Defense Directive 5500.11; May 27, 1971) issued pursuant to that Title, to the ends that, in accordance with Title VI of that Act and Directive, no person in the United States shall, on the grounds of race, color, or national origin, be excluded from participation in, be denied benefits of, or be otherwise subjected to discrimination under any program or activity for which the Applicant received Federal financial assistance from the Department of the Navy and HEREBY GIVES ASSURANCE THAT it will immediately take any measures necessary to effectuate this agreement.