REQUEST HANDS ON SCIENCE

REQUEST HANDS ON SCIENCE

You need to be a principal, teacher or authorized PTA representative to make a request. Please email JNewman@DiscoveryCtr.org if you are interested but are not a Principal, PTA representative or teacher at the school.
Please read before filling out this form. Page 2 is FAQs for parents
Person Requesting The Event
Program is designed for grades K-5
If your school does not appear, please email JNewman@DiscoveryCtr.org
School is in
We prefer
Choose a town in Dutchess we serve
If you do not see your town email JNewman@DiscoveryCtr.org
Choose a town in Upper Westchester we serve
If you do not see your town email JNewman@DiscoveryCtr.org
Choose a town in Lower Westchester including White Plains
If you do not see your town email JNewman@DiscoveryCtr.org
Name

First NameLast Name
Your Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please select phone type
Extension
School Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred weeknight program (only available in some towns)

MonthDayYear
Date
Back Up Preferred weeknight program (only available in some towns)

MonthDayYear
Date
Preferred Saturday date

MonthDayYear
Back Up Saturday date

MonthDayYear
Should be Empty: