Science Squad Presentation Request Form

Complete all the requested fields below. Science Squad presentations will be available from mid-September through the end of May. Teachers may request up to four presentations during the school year. The form below will allow 4 plus an alternate.

Name(first and last)*:
Name of School*:
School Address:
(include city and zipcode)
School District
School District (If not shown above)
Email Address:
School Phone:
Home Phone*:
How would you like to be contacted? Email Phone
Grade Level:
Number of Classes:
Class length time:

When selecting dates, please consult with your school calendar for planning dates, special events, TCAP testing, etc. If you are making a request for a block scheduled class that requires the Science Squad member to be present two days to reach all of your students, it will be considered 2 presentations of your 4 presentation limit.

Presentation 1: When:
Additional Comments:

Presentation 2: When:
Additional Comments:

Presentation 3: When:
Additional Comments:

Presentation 4: When:
Additional Comments:

Alternate Presentation: When:
Additional Comments: