Family Science Night Application for 2023 - 2024
Thank you for your interest in the Children's Science Center Lab's Family Science Night program for the 2023 - 24 school year. Please note the application MUST be submitted with the knowledge and consent of the school. One application is accepted per school. All fields are required.
School/Organization Information
School/ Organization Name
*
Address
*
Street address, City State, Zip Code
County
*
Is this application for a Title 1 school?
*
Yes
No
What percentage of the student population is eligible for free or reduced-price meals?
*
What percentage of the student population is ELL/ESL?
*
Name of Administration Contact
*
Principal or Assistant Principal
Point of Contact Information
The person who will be involved in setting up the event on the school/organization's side.
Name
*
First Name
Last Name
Title
*
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Requested Dates
Please enter four (4) dates in order of preference, on Tuesdays and Thursdays only, September 2023 through April 2024. We will do our best to accommodate your first request.
*
-
Month
-
Day
Year
*
-
Month
-
Day
Year
*
-
Month
-
Day
Year
*
-
Month
-
Day
Year
Submission of this application indicates the school/organization agrees to the following obligations. Failure to comply with the terms of this agreement may lead to forfeiting your scheduled event or ineligibility to participate in future events.
I have read and agree to the obligation listed in the Family Science Night Obligations 2023 - 2024 document.
*
I agree
This Family Science Night application is submitted with the knowledge and consent of the school/organization.
*
Yes
United Bank is the premier sponsor for Family Science Night in the 2023 - 2024 school year.
Submit
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