Outreach Request Form

Outreach Request Form

Book Sturgeon City to bring science fun to your site! Outreach's are typically 1 hour long with 2 science stations.
Your signature confirms your agreement to our terms of visit and reserves your outreach from Sturgeon City as stated below.

If you have any additional questions, please contact our Program Coordinator at (910) 750-5876 or at programming@sturgeoncity.org.

-Cost will be discussed individually for each outreach depeneding on mileage, time, etc.

-Payment is due the morning of the outreach.

- We will arrive approximately 30 minutes prior to the start time of your program.
Organization Name*
Organization Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Contact Person*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Number of Students Participating*
Date Requested for Outreach*

MonthDayYear
Subject to change depending on Sturgeon City's schedule
Requested Time:*
Grade or Age Range*
Topic Selection (from field trip page)*
List 2 topics. If no preference the write "no preference" and staff will pick the most popular for the grade level
Notes or Comments
Signature (please type name to acknowledge that you read the information at the top of the page)*
Should be Empty: