STARBASE Edwards Interest Form
Please fill out this form ASAP if your school, or district, is interested in attending STARBASE's program during the 2023-2024 school year. We have limited spots for schools and so filling out this form early is imperative to ensure that your school, or district, gets scheduled as close to your desired date as possible. Please note: STARBASE needs two points of contact (POCs) to complete this form; one of which needs to be at either a school or district leadership level.
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District Name (No Abbreviations please):  *
School Names (No Abbreviations please):  *
Number of Classes:  *
Each school needs to provide the number of 5th grade classes (or 5/6th combos) they would like to attend. Each 5th grade class represents one spot at STARBASE, so it is important for us to have exact numbers when scheduling. 
School Addresses:  *
Desired Quarter For STARBASE Attendance (Check Multiple Options If You Have Scheduling Flexibility): *
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