Summer STEM from Your Library Response Form
Earn a gorilla by completing this form. PLEASE NOTE that you may only earn a gorilla by doing a Summer STEM activity that is released between JUNE 15-JULY 27. Any STEM or STEAM activities that are NOT from THIS summer DO NOT COUNT. This program is made possible by the Idaho Commission for Libraries and the Idaho STEM Action Center!
Name of Child/Children
*
First Name
Last Name
Tell us about your experience
Please rate the following statements:
*
Strongly Agree
Agree
Neutral
Disagree
Strongly Disagree
My child (or children) learned something during this program.
My child (or children) engaged with a STEM concept during this activity.
My child (or children) was able to describe what they learned.
Our family enjoyed this program.
STEM Photo Options
File Upload
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Drag and drop files here
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Upload your STEM photo here or show it to the librarian at the Children's Reference Desk to pick up a gorilla.
Cancel
of
I prefer not to upload a photo and will instead show a photo to the librarian at the Children's Reference Desk when I pick up a gorilla.
YES, you may use the photo I have sent for Madison Library District or Idaho Commission for Libraries to use in venues deemed appropriate by their staff. Parent/Caregiver Signature:
NO, you may not use the photo.
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