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After School Program Request Form
Contact Information
School or organization name:
Contact name:
Position:
Phone number:
Email address:
Program Details
Earliest preferred start date:
Number of Sessions (Must be at least 4):
Preferred Time & Day of the Week:
Program Topic
Crazy Chemworks
Minerals, Machines, and Movies
Brixology (Grades 1 and Up Only)
Mission: Code (Must have computer lab access)
Red Hot Robots (Contains additional lab fees)
Other
Grade Range:
Additional Requests & Comments
Use the box below to give us any other pertinent information.
Comments:
Please send me special offers and cool experiments
Submit