Events & Programs Science on Wheels Registration Form Program Information Number of Participants*Are you a...*Local School (Located in King, Snohomish or Pierce County)Regional School (Outside of King, Snohomish or Pierce County)LibraryOtherProgram Choice (Check all you are interested in)* Package 1 (schools only): This Whole School Experience includes an assembly, 16-20 workshops and a full day of exhibits. Recommended for up to 630 students Package 2 (schools only): This Whole School Experience includes an assembly, 11-15 workshops and a full day of exhibits. Recommended for up to 470 students Package 3 (schools only): This Whole School Experience includes an assembly, 6-10 workshops and a full day of exhibits. Recommended for up to 310 participants Exhibits: We transform a large, indoor space into a "science playground" with tabletop exhibits, experiments and activities focused on your chosen science topic. Science Shows: A 40-minute live science shows present your chosen science topic in a compelling and fun presentation. Science Workshops: Engaging, content-rich, and hands-on workshops taught by our educators. Planetarium Experience: Our educators guide participants through the night sky in a live, interactive show held inside our inflatable planetariums or in classrooms. Topic Choice (Check all you are interested in)* Blood and Guts Engineering Mathblast Physics On Wheels Rock and Roll Space Odyssey How Many Days of Programming?*What Time Would the Program Start?*Date(s) or Month Preferred?*Flexible on Date(s): Yes or No*YesNo School Information Name of School*Address* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*County*School District*Are you interested in receiving a scholarship?YesNoFree and Reduced Lunch Rate* Contact Information Person organizing the Event* First Last Position*Email* Phone*Will the person organizing the event also be paying for it?*YesNoCommentsNameThis field is for validation purposes and should be left unchanged.