STEAM Night Request Form (Sci-Tech At Your School)

Booking Type *

Begin Booking Process
Quote Inquiry

*Please note that if you choose Quote Inquiry then you will not be added to our booking calendar. If you choose to move forward after recieveing your quote then you will need to contact us via phone, email, or fill out a new form. Prefered dates will not be saved.

Contact Information

Organizer Contact Name *

First

Last

Organizer Email *

Contact Phone *

Is the Organizer Contact the same as the Day of Contact? *

Yes
No

Day of Contact Name *

First

Last

Day of Email *

Day of Phone *

School / Organization *

School District *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Location of the STEAM Night the same as the adress listed above? *

Yes
No

STEAM Night Address *

Address Line 1

Address Line 2

City

State

Zip Code

Are you 15 miles or further from Sci-Tech? *

No
Yes

Miles from Sci-Tech *

Estimated Mileage Cost

Title One Sponsorship Opportunity

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

STEAM Night Request Info

*Estimates are ok!

Grade Level(s) *

Total # of Students *

The package is designed for 200 students. If your estimated headcount exceeds this we will contat you with an updated quote.

Special Accomidations Needed? *

Yes
No

What Special Education Accommodations Needed?

Outreach Requests

Outreach Date / Time Preference 1 *

Date

Time

Outreach Date / Time Preference 2 *

Date

Time

Outreach Date / Time Preference 3

Date

Time

STEAM Night Packages include 2 Sci_Tech Staff Members for 2 hours. If you would like to inquire about additional time or activities please do so in the note section.

Additional Activity: (added cost)

Additional WOW! Show ($250)

Today's Date: *

*Requests are not guaranteed Reservations.

Reservations 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.

Notes: