Request Form – Outreach (School Year ’25 -’26) – Sci-Tech Discovery Center

Request Form Purpose *

Free Quote Inquiry
Begin Booking Process

Please note that quotes do NOT reserve dates or times. Quoted prices are estimates only and may not reflect final amount due. Deposits are due 30 days prior to trip date to secure booking reservations. If you have questions, please contact us.

Contact Information

Contact Person *

First

Last

Role

Contact Email *

Email

Confirm Email

Contact Phone *

Is contact person different than day-of contact? *

Yes
No

Day-Of Name *

First

Last

Day-Of Phone *

Day-Of Email *

Email

Confirm Email

School / Organization Information

School / Organization Type

School / Organization *

School District *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Outreach Location Information

Outreach Type *

In Person (At your school)
Virtual

Please note that schools outside a 15 mile radius will be charged a travel fee.

Is the address listed above the same as where the outreach will be preformed? *

Yes
No

Address of Performance Location *

Address Line 1

Address Line 2

City

State

Zip Code

Is your outreach location further than 15 miles from Sci-Tech? *

No
Yes

Miles from Sci-Tech *

Estimated Milage Cost

Outreach Request Info

Grade Level(s) *

Total Students Headcount *

Estimated Total Pre-K4 *

If unsure, please provide the maximum. Adjustments can be made upon invoicing.

Estimated Total Kinder *

If unsure, please provide the maximum. Adjustments can be made upon invoicing.

Estimated Total 1st *

If unsure, please provide the maximum. Adjustments can be made upon invoicing.

Estimated Total 2nd *

If unsure, please provide the maximum. Adjustments can be made upon invoicing.

Estimated Total 3rd *

If unsure, please provide the maximum. Adjustments can be made upon invoicing.

Estimated Total 4th *

If unsure, please provide the maximum. Adjustments can be made upon invoicing.

Estimated Total 5th *

If unsure, please provide the maximum. Adjustments can be made upon invoicing.

Estimated Total 6th - 8th *

If unsure, please provide the maximum. Adjustments can be made upon invoicing.
Note: If 50% or more of your students are 6th-8th grade, please go to our Middle School Outreach Form instead!

Special Education Accommodations Needed?

Does your school receive Title 1 funds? *

Yes
No

*Your school may be grant recipient eligible

What percentage of your school is low income?

More than 40%
Less than 40%
Unsure

Outreach Date / Time Preference 1 *

Date

Time

Outreach Date / Time Preference 2 *

Date

Time

Outreach Date / Time Preference 3

Date

Time

Full descriptions and grade levels found in our Educator's Guide! (Link opens new page.)

WOW Stage Shows: (30-45 minute shows held in classrooms or auditoriums for up to 200 students at a time)

$350 for the first performance, $200 for each additional performance of the same activity.

Learning Labs: (30-45 minute classroom programs held for up to 30 students at a time)

$250 for the first Learning Lab class, $200 for each additional classroom on the same day of the same lab
*Marked Learning Labs have a material cost per classroom.

*Requests are not guaranteed Outreach Reservations.

Outreaches are only guaranteed once a signed contract and deposit have been received.

If you have any questions, please contact our booking department at bookit@scitechdiscovery.org, or call us at 469-896-2188 X2.

Today's Date: *

Notes:

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