Event Request Form

School or organization name:

Contact name:

Position:

Phone number:

Email address:

1st Choice:

Occasion(Science Night, Assembly, etc.) Please supply 2nd/3rd choice date. :

Tell us what you are interested in:

  Shows (performance for 30-175 children)

  Demonstration Activity Stations

  Make-and-Take Fun Stations (includes take home project)

  Event will be during the school day

  Event will be held in the evening

  Event will be on the weekend

  We have volunteers to staff some stations to reduce cost

Use the box below to give us any other pertinent information.

Comments: