Outreach Reservations Form School/Organization Name* School/Organization Complete Mailing Address* School/Organization Phone Number* Contact Full Name* Contact Phone Number* Contact Email* Please select type of school/organization*SelectPublicPrivateCharterMagnetHomeschoolOtherIs your school part of the MDCPS?SelectYesNoIf yes, does your school receive Title 1 funding?SelectYesNoGrade level of students/participants* Number of students/participants attending the outreach* Frost Science is dedicated to offering a memorable experience for all students/participants, including those with special needs. Please help us prepare for our visit by telling us about your students/participants and any modifications or accommodations they may need. Please check any of the categories below that apply to your students/participants.* Gifted ELL/ESOL (English Language Learners/English for Speakers of Other Languages) Advanced Placement Program (AP) Wheelchair Accessibility or Orthopedic Impairment Autism Spectrum Disorder (ASD) Montessori Education Deaf/Hard of Hearing Emotional/Behavioral Disability Intellectual Disability Honors Class Speech or Language Impairment Low or No Vision Does your group have any accessibility needs or require any special accommodations that are not listed above or require further explanation? Please tell us anything else about your group, so we can better plan our visit.Please list below, in order of preference, the date your group would like to have this outreach.Preferred Date #1:* Preferred Date #2:* Preferred Date #3:* Please share your preferred start time* Please select your outreach option:*SelectCatapult Engineering ChallengePortable MuseumCircuitry ChallengeGeology Rocks!Power of PlasmaThe Chill Zone: Liquid NitrogenNight Sky Telescope ViewingPortable PlanetariumBuild Your Own OutreachBy submitting this reservation, you are requesting an outreach program from Frost Science. If the date requested is available, an invoice will be emailed to the person submitting this form within 5 business days. Please note, that a 20% deposit is required to hold your outreach date. Full payment is due 10 business days before your outreach program. CAPTCHA