Onsite 1-Hour Hands-on Lab Session Request

Please provide the following information so that we may provide you with an accurate quoter a science session or sessions at your location!

Name of school or organization

Address for location

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact person name

First Name

Last Name

Contact person email

Contact person phone

(###)

###

####

Estimated minimum number of participants

Estimated maximum number of participants

Age range for participants

Specific date or range of dates for event

If multiple dates, indicate which days of the week sessions can be conducted.

Please list alternate dates in the order of the most preferred (in the event that your 1st choice date cannot be accommodated).

How many sessions, if more than one

Time frame of event/s

What size group can attend each session?

Do you have a single room or area large enough for your group with access to water on-site?

Are portable tables without seating attached available for us to use ( 8-10 participants per 10' table)

What additional details about your group should we know?