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Jack Kilby STEM Day School Sponsor Registration
Jack Kilby STEM Day
November 19, 2018, 8 a.m. - 2 p.m.
Keynote Speaker: Kantis Simmons 'STEM Is Everywhere'
Barton Community College
245 NE 30 Road
Great Bend, KS 67530
Contact us at (620) 792-9200 or for more information!
Email address *
Sponsor's First Name *
Your answer
Sponsor's Last Name *
Your answer
Sponsor's School Information
Please help us update our records by providing your school's contact information in the following questions.
Sponsor's School *
Your answer
Sponsor's School Street Address *
Your answer
Sponsor's School City *
Your answer
Sponsor's School Zip Code *
Your answer
Sponsor's School Phone Number *
Your answer
Please provide the anticipated number of attendees below.
Anticipated Number of Adults Attending *
Please include yourself here.
Your answer
Anticipated Number of Students Attending *
Number of students you anticipate will register with you as their sponsor.
Your answer
Anticipated Number Attending Sponsor-Only Breakout Session with Kantis Simmons *
Please include yourself if you plan to attend the sponsor-only breakout session with Kantis Simmons.
Your answer
If unable to attend, please contact us at
Thank you for your participation in JKSD 2018!
Charlotte Cates
On behalf of the Jack Kilby Planning Committee
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