Request a Program at Your Site

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Please submit this form to request a Science Show, Festival, or Workshop to be held at your site. Our Registration Office staff will email you to complete your reservation.

Your Full Name *

Your Phone Number *

Your Email *

Re-enter Your Email to Confirm *

School or Group Name *

School or Group Address of Your site *

City *

State *

Postal (Zip) Code *

School or Group Phone Number *

School or Group Fax Number

Contact Person at School *

How many students total are attending? *

How many students are in each class? *

1-20

21-25

26-32

Over 32

What grade(s) are the students in and how many students are there per grade level? *

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