Education Council, Science Center Request Form

SCIENCE CENTER REQUEST FORM

To request a visit to the Science Center, please complete the form below and submit your request.

You will be contacted within 2 business days with a confirmation.

School Name:

Teacher to Contact:

Telephone Number:

Email Address:

Best time to contact:

Grade Level:

Please list the grade level of students for the requested visit.

Number of Students:

If the group is larger than 25 students, we suggest splitting the group into two with half the students in the Science Center, while the other half is on plant tour.

Type of Request:

Science Center Module Overview

Plant Tour

Overview of Rock to Phosphate

Proposed Dates:

Please list your desired choice of dates to visit the Science Center.

Proposed Time:

Please list the desired choices for the time of day you would like to begin your visit to the Science Center.

Field Trip Length:

Module Requested:

Please list the area of current study and/or the module to be reviewed during the visit.

Financial Assistance:

Yes

Are you are interested in Simplot possibly helping cover the cost of the bus for this field trip?

Number of Miles:

Please indicate the estimated number of round-trip miles from your location.