5th Annual STEM Exploration Community Event - Participant Registration Form

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We are so excited that you will be joining us for the 5th Annual STEM Exploration Community Event! The event will take place at Professional Workforce Development Center: 600 Butler Farm Road, Suite A Hampton, VA 23666 on Saturday, November 8th from 10 a.m. - 2 p.m. Learners of all ages are welcome to attend. Minors must be accompanied by an adult. The event will feature hands-on exhibits by a range of organizations, door prizes, speakers, and activities.
To learn more about the event, please visit our website.
Please plan to check in at the Welcome Table to receive your door prize tickets immediately upon arrival.
The data collected via this form will not be shared with an outside party. The information provided on this form will be used by the event coordinators to prepare for your visit and to send a follow-up event survey.
For questions or concerns please reach out to covastemhub@gmail.com with the subject line titled "2025 STEM Exploration Community Event".

Email *

First Name *

Last Name *

ZIP/Postal Code (example: 23669) *

Phone Number (with area code) *

How many minor children will attend the event with you? *

Please provide the ages of the children attending with you. Select all that apply. *

0-4

5-7

8-10

11-13

14-16

17-18

Other:

Required

How many adults will be at the event with you? *

What school district does your child / do your children attend? Select all that apply. *

Chesapeake City Public Schools

Hampton City Schools

Hampton City Schools - 21st Century Program (Out of School Time Program)

Homeschool

Isle of Wight County Schools

Newport News City Public Schools

Norfolk Public Schools

Poquoson Schools

Portsmouth Public Schools

Suffolk Public Schools

Virginia Beach City Public Schools

Williamsburg-James City County Public Schools

York County School Division

Accomack County Schools

Franklin County Schools

Gloucester Public Schools

Northampton County Public Schools

Southampton County Schools

Other:

Required

How did you hear about the event? *

School Division Communication

Daily Press/Virginia Pilot

Social Media (Facebook, etc.)

Flier posted in church or business

Newsletter from STEM organizations

Other:

Check to confirm Parent/Guardian Consent for photographing minor that could be used in COVA STEM Hub media or social media ventures. *

I agree

Required

Thank you for completing this form. We look forward to seeing you on November 8th! Please be sure to hit the submit button. If you successfully register, you will receive a copy of your registration. If you do not receive a copy, please reach out to covastemhub@gmail.com.

A copy of your responses will be emailed to the address you provided.

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