Student Workshop Equipment Grant Form

$250 Grants for Your School

To be eligible to participate in the Equipment Grant, you must have recently attended a Science Week Student Workshop. This grant will enable you to purchase equipment demonstrated in the workshops or other science-related equipment of your choice. All equipment will be shipped directly to your school address.

The grant amount is $250 and must be ordered from Fisher Scientific

Click here for the online catalog

No grant requests will be accepted after the deadline of December 2, 2016

Have a Question?

Don Antczak
antczak@pittcon.org

Marc Hubert
hubert@pittcon.org

800-825-3221, x208

Equipment Grant Order Form

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School Info & Shipping Info
Teacher Name*
School Name*
Email Address*
Phone Number*
School Address*
Street Address Address Line 2 City State ZIP Code
If submitting for multiple teachers, please list all teacher names
Orders must be placed using one of our 4 participating suppliers:
Supplier Info*
1st Item
Item 1 - Item # / SKU*
Item 1 - Cost*
Item 1 - Quantity*
Item 1 - Title / Description*
Item 1 - Total Cost*
2nd Item
Item 2 - Item # / SKU
Item 2 - Cost
Item 2 - Quantity
Item 2 - Title / Description
Item 2 - Total Cost
3rd Item
Item 3 - Item # / SKU
Item 3 - Cost
Item 3 - Quantity
Item 3 - Title / Description
Item 3 - Total Cost
4th Item
Item 4 - Item # / SKU
Item 4 - Cost
IItem 4 - Quantity
Item 4 - Title / Description
Item 4 - Total Cost
5th Item
Item 5 - Item # / SKU
Item 5 - Cost
Item 5 - Quantity
Item 5 - Title / Description
Item 5 - Total Cost
6th Item
Item 6 - Item # / SKU
Item 6 - Cost
Item 6 - Quantity
Item 6 - Title / Description
Item 6 - Total Cost
7th Item
Item 7 - Item # / SKU
Item 7 - Cost
Item 7 - Quantity
Item 7 - Description
Item 7 - Total Cost
8th Item
Item 8 - Item # / SKU
Item 8 - Cost
Item 8 - Quantity
Item 8 - Description
Item 8 - Total Cost
9th Item
Item 9 - Item # / SKU
Item 9 - Cost
Item 9 - Quantity
Item 9 - Description
Item 9 - Total Cost
10th Item
Item 10 - Item # / SKU
Item 10 - Cost
Item 10 - Quantity
Item 10 Description
Item 10 - Total Cost
11th Item
Item 11 - Item # / SKU
Item 11 - Cost
Item 11 - Quantity
Item 11 - Description
Item 11 - Total Cost
12th Item
Item 12 - Item # / SKU
Item 12 - Cost
Item 12 - Quantity
Item 12 - Description
Item 12 - Total Cost
13th Item
Item 13 - Item # / SKU
Item 13 - Cost
Item 13 - Quantity
Item 13 - Description
Item 13 - Total Cost
14th Item
Item 14 - Item # / SKU
Item 14 - Cost
Item 14 - Quantity
Item 14 - Description
Item 14 - Total Cost
15th Item
Item 15 - Item # / SKU
Item 15 - Cost
Item 15 - Quantity
Item 15 - Description
Item 15 - Total Cost
16th Item
Item 16 - Item # / SKU
Item 16 - Cost
Item 16 - Quantity
Item 16 - Description
Item 16 - Total Cost
17th Item
Item 17 - Item # / SKU
Item 17 - Cost
Item 17 - Quantity
Item 17 - Description
Item 17 - Total Cost
18th Item
Item 18 - Item # / SKU
Item 18 - Cost
Item 18 - Quantity
Item 18 - Description
Item 18 - Total Cost
19th Item
Item 19 - Item # / SKU
Item 19 - Cost
Item 19 - Quantity
Item 19 - Description
Item 19 - Total Cost
20th Item
Item 20 - Item # / SKU
Item 20 - Cost
Item 20 - Quantity
Item 20 - Description
Item 20 - Total Cost
21st Item
Item 21 - Item # / SKU
Item 21 - Cost
Item 21 - Quantity
Item 21 - Description
Item 21 - Total Cost
22nd Item
Item 22 - Item # / SKU
Item 22 - Cost
Item 22 - Quantity
Item 22 - Description
Item 22 - Total Cost
23rd Item
Item 23 - Item # / SKU
Item 23 - Cost
Item 23 - Quantity
Item 23 - Description
Item 23 - Total Cost
24th Item
Item 24 - Item # / SKU
Item 24 - Cost
Item 24 - Quantity
Item 24 - Description
Item 24 - Total Cost
25th Item
Item 25 - Item # / SKU
Item 25 - Cost
Item 25 - Quantity
Item 25 - Description
Item 25 - Total Cost
Total Grant Request

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Student Workshop Equipment Grant Form

$250 Grants for Your School

The grant amount is $250 and must be ordered from Fisher Scientific

Click here for the online catalog

No grant requests will be accepted after the deadline of December 2, 2016

Have a Question?

800-825-3221, x208

School Info & Shipping Info

1st Item

2nd Item

3rd Item

4th Item

5th Item

6th Item

7th Item

8th Item

9th Item

10th Item

11th Item

12th Item

13th Item

14th Item

15th Item

16th Item

17th Item

18th Item

19th Item

20th Item

21st Item

22nd Item

23rd Item

24th Item

25th Item

Grant submissions are now closed.

Science Week Pittsburgh | 800-825-3221, ext 208 | scienceweek@pittcon.org