Request Form

Thank you for your interest in the K-12 Visiting Scientists Program. You will be required to complete a form for each class/grade level for which you are requesting a presentation. After filling out a form for one class you will have an option to fill out the form again for another class with the general information (name, school, etc.).

Please note that due to high demand for the Visiting Scientists program, there are a limited number of presentation dates that can be accommodated each semester. Requests will be scheduled on a first come, first served basis.

In order to ensure a rewarding experience for host schools, students and presenters we ask that you follow these guidelines:

  • Complete and submit the Request Form (the form will go directly to all requested faculty). Arrangements will be made directly between each presenter and the requestor.
  • Once arrangements have been made please plan to confirm the date, time, location and parking details with all presenters the week before a presentation is to be given.
  • Plan to discuss any special arrangements the presenter may need in regard to space, and equipment. Some presentations will necessitate arrangements for bringing in numerous and in some cases heavy props.
  • If the presenter is scheduled for multiple presentations over the course of a day please let them know where they can find accommodations for rest room facilities, break/prep area and lunch.
  • A teacher must remain with the class at all times.
Name
This is a required question
What is your title
teacher, classroom assistant, etc.
This is a required question
E-Mail
preferred method of communication
Please enter a valid email address
Phone
secondary method of communication
Please enter a valid phone number
Name of School
This is a required question
Address
This is a required question
Grade Level
This is a required question
Number of students in your class
Must be a whole number
Presentation Title
Options will display when you select a grade level
This is a required question

Possible Dates

Suggested Dates 1
This is a required question
Suggested Dates 2
This is a required question
Suggested Dates 3
This is a required question
Suggested Dates 4
This is a required question
Suggested Dates 5
This is a required question