K-12 STEM "Expert" Request Form
The CMSE can help coordinate in-class demonstrations or guest speakers.
Contact Information
School Name *
Your answer
Teacher First Name *
Your answer
Teacher Last Name *
Your answer
School Physical Address *
Your answer
City *
Your answer
State *
Zip Code *
Your answer
Country *
Your Preferred Email Address *
This will be the email address that will be used to contact you.
Your answer
Phone Number *
please use this format: 662-XXX-YYYY
Your answer
How many students will participate? *
Your answer
Grades of Students *
Select grades of all students that will be observing the demonstration/guest speaker.
Required
Arrival Date: (1st Choice)
MM
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DD
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YYYY
Arrival Date: (2nd Choice)
MM
/
DD
/
YYYY
Ideas *
Please select the experiences that you would like your students take part in. If you are not interested, please indicate on the form.
Top Choice
Maybe
Not Interested at this time
Physics Demonstration or guest speaker
General Engineering Demonstration or guest speaker
Robotics demonstration or guest speaker
Mathematics guest speaker
Mechanical Engineering Demonstration or guest speaker
Chemistry Demonstration( limit to groups of 25 or less)
Please enter any additional information that we may need.
Your answer
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