RAMP UP Order Form FA23

RAMP UP Kit Order Form

Hi teachers! This is the form to order a RAMP UP kit. If another teacher from your school wants to use the same kit at the same time as you, he/she should fill out their own Order Form to receive a refill of the consumable equipment. If you have any questions/concerns please feel free to reach out to rampup@uah.edu.
Teacher Information
Name*

First NameLast Name
Email (Please double check)*
example@example.com
Phone Number*
Please enter a valid phone number.
School Name*
School Mailing Address (Please double check)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Which kit are you ordering?*
Please double check this. If you select the wrong kit, you'll receive the wrong kit.
Does someone at your school already have this kit on-hand right now?*

No, I'll need the full kitYes, I just need a refill of the consumable equipment for my class
When do you want to receive this kit? We'll try our best to meet this request.*

As soon as possibleOther (click to type a date)
How many CLASSES at separate times are you doing this kit with? Do not include any other teachers' classes that want to do this kit - they'll fill out their own order form.*
You are eligible for as many High-Altitude Balloons (HABs) as the number of classes you listed above. Please list the number of balloons you would like to receive. *
How many HABs would you like to receive. This value should be between 1 and your number of classes.
How many total STUDENTS are you doing this kit with? Do not include any other teachers' students that want to do this kit.*
What grade do you teach?*

Kindergarten1st2nd3rd4th5thOther (click to type in an option)
What subject do you teach?*

Every subjectMathScienceEngineering or Computer Science-relatedCounselingLibraryP.E.Other (click to type in an option)
How did you hear about RAMP UP?*

Another teacherA principalOther AdministrationI attended the UAH Teacher WorkshopOther (click to type in another option)
Teacher or Principal's email who recommended RAMP UP*
Comments:
Please read the following and agree to it below. If you have questions, email rampup@uah.edu.

Please ACTUALLY read it.
By typing my name below, I understand that by ordering this free RAMP UP kit, I'm agreeing to the following:
- I plan to perform the activity/experiment from the kit within ~2 weeks of receiving the kit.
- After the activity, I'll fill out the teacher feedback form listed under the kit's instruction webpage and submit pictures of the activity/experiment and the kids' reactions on this form.
- I will return the non-consumables of the kit back to UAH after the activity within 3 weeks of receiving the kit (unless another teacher uses the kit immediately after me), using the prepaid shipping method given by UAH or by emailing rampup@uah.edu for further instructions.
- If I don't submit pictures, fill out the feedback form, OR don't return the kit non-consumables, I understand that I may be unable to receive equipment in the future.
I have ACTUALLY read and agreed to the above text (Type name in box).*
Name
What are the 3 things you HAVE to do to stay eligible for future kits?*

Fill out the feedback form after completing the kitSubmit pictures on the feedback formReturn non-consumables
Please read the agreement again to answer the above question correctly.
Comments:
Should be Empty:

RAMP UP Kit Order Form

Teacher Information

Please read the following and agree to it below. If you have questions, email rampup@uah.edu.