Explorit Science Center
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Program reservation information including cancellation policy

Requesting: Classroom Programs at School Site

Please note that your program request will depend upon date and time availability.
A. Check the Program Reservation(s) being requested   [Fee Information]
Classroom Adventure(s): Grade levels vary by topic as indicated in pull-down menus below: Group Size: Up to 35 children - A minimum of 1 adult must accompany the group.   Availability: Weekdays; Up to 4 groups per day; Up to 2 different topics per day.   Location: At your school or site.   Length: 60 minutes (at least 15-minute break between groups is required)
Young Scientist Series: Grade Level: 1-6 (grade levels may be combined).   Group Size: Up to 25 students after school or 35 students during school day - a minimum of 1 adult must accompany the group.   Length: Four 60 to 75-minute sessions per group.   Availability: Weekdays for up to 2 groups; One topic per day

B. Provide Applicant Profile

IMPORTANT: Use [tab] key to move from one field to the next.
Contact Person Name and Title:
School Name:
School Street Address (including city, state, zip):
Billing Address if different:
Contact: school phone number (with area code)
Contact: cell phone number (with area code)
Contact: home phone number (with area code)
Contact e-mail
School District and county name
Day(s) of the week and time(s) that contact is available for follow-up phone discussion:

C. Please indicate the details for the program you wish to reserve by completing each field for that program (Please leave fields of other programs blank)

IMPORTANT: Use [tab] key to move from one field to the next.
Classroom Adventures:
provide 3 possible dates   (Note that multiple classes must be on same day)
How many groups on this occasion for Classroom Adventures at your site?
Select topic for first group: (or only group)
   
Grade level and number of students in first group
Teacher Name; and Time of first group
 
Select topic for second group:
   
Grade level and number of students in second group
Teacher Name; and Time for second group
 
Select topic for third group:
(Remember, only 2 topics per day)
   
Grade level and number of students in third group
Teacher Name; and Time for third group
 
Select topic for fourth group:
   
Grade level and number of students in fourth group
Teacher Name; and Time for fourth group
Use this space for a comment or question about the request for this program:

Young Scientist Series desired day of week and dates:
Grade level and number of students
Topic:
   

alternate topic reqest:
Start Time:
For another group on the same day
Grade level and number of students
Start Time:
Comment or Question:



Explorit Science Center
P.O. Box 1288
Davis, CA 95617
Phone: 530.756.0191
Fax: 530.756.1227