PittconScience WeekScience Lecture & Demo Reservation Form

Science Lecture & Demo Reservation Form

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Come share in the excitement of science education at Pittcon 2013!

Space is limited and selection of schools will be on a first-come, first-served basis (provided the school’s times of arrival and departure meet the schedule of the activity). Please note: each school MUST have one adult chaperone per 20 students.

The deadline for applications is March 8, 2013. Submitting an application does not guarantee your group a space in the program. A confirmation will be sent via email.

QUESTIONS? Call 1-800-825-3221, ext. 208 or email us at ScienceWeek@pittcon.org




Teacher Name:*

Email Address:*

Daytime Phone:*

Evening Phone:*

Address:*

Address 2:*

City:*

State:*

Zip Code:*

School Name:*

Number of Students Attending:*

Number of Adults Attending:*

Earliest possible arrival time at the convention center:* (A.M.)

Latest possible departure time from the convention center:* (P.M.)

 

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