Mobile Science Lab Booking Request Form
To request a Mobile Science Lab visit during the 2026-27 school year, please complete and submit the following booking information. We will process requests in the order they are received
School Name
*
Requesting Person
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Booking Request
Details about your booking
Has the Mobile Science Lab visited your school before?
*
Yes
No
Would you like to be considered to receive a $500 ReBooking Sponsorship for the 2026-27 school year, if available?
Yes, we would appreciate the discount if it is available.
No, thank you. We do not need the discount at this time.
Would you like to be considered to receive a $1000 NEW Booking Sponsorship for the 2026-27 school year, if available?
Yes, we would appreciate the discount if it is available.
No, thank you. We do not need the discount at this time.
We are interested in a
*
Full 5 day week, accommodating @ 25 classes ($2000)
a 3 or 4 day shortened week, accommodating @ 15-20 classes ($1800) This option is only available on weeks naturally shortened due to a holiday.
Not sure exactly what we might need
Which grades would you like to have participate?
How many total classes would you be looking to include in the visit?
Which lab would you like?
*
Please Select
Ag Products Lab
Aquatics
Food, Fiber & You Lab
Not sure which our our labs will bese meet your needs? Learn more below about each lab's theme and content focus!
1st CHOICE Week Selection: Please choose the FIRST DAY of the week you are interested in.
*
2nd CHOICE Week Selection: Please choose the FIRST DAY of the week you are interested in.
*
3rd CHOICE Week Selection: Please choose the FIRST DAY of the week you are interested in.
*
Special Request or Question
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Booking Info
Scheduled for:
# Days:
Fee:
Sponsorship:
Sponsorship Amount:
School Information
Please fill out your school information below
School Name
*
County
*
School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
School Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Principal Name
*
Principal Email
*
example@example.com
Visit Coordinator Information
In preparing for our visit to your school, we need a primary contact person who can assist with establishing all the visit details, including providing hte school's master schedule in order for our staff to develop the customized scheudle for the visit, and arranging for delivery of the lab. Typically, this would be someone within the school, such as principal, assistant principal, secretary, or lead teacher.
Visit Coordinator Name
*
First Name
Last Name
Position
*
Email
*
example@example.com
Retype Email to Verify
*
example@example.com
Emergency Delivery Contact Information
We need an emergency delivery contact in case we need to reach someone outside school house regarding the delivery of the lab. This person is responsible for knowing where the lab is to be parked and providing access to the school (if necessary).
Emergency Contact Name
*
First Name
Last Name
Home Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
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Agreement/Invoice Contact Information
We will be sending out the agreement and invoice via email. Please fill out the information below so we know where to send it and to whose attention should the agreement and invoice be sent?
Agreement/Invoice Contact Name
*
First Name
Last Name
Entity/Organization (if necessary)
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Agreement/Invoice Email
*
example@example.com
Retype Email to Verify
*
example@example.com
Submit
Should be Empty: