Science on Wheels Assembly Registration Form
Please scroll down and fill out the form below to request a Science on Wheels assembly program visit from Roper Mountain Science Center.

If you would like to request a Starlab visit instead, please go to the website below and click the registration link there:

https://www.ropermountain.org/main.asp?titleid=starlabportplan

If you would instead prefer a public Science on Wheels program (good for library programs, Science Nights, camps and community events) please visit the website below and click the registration link there.

https://www.ropermountain.org/main.asp?titleid=sowpublic

If you have difficulty with this form, or if you do not yet have enough details to complete the request form, but would like to hold a date or get more information, please contact the Outreach Specialist, Jennifer Romatelli at jromatelli@greenville.k12.sc.us or 864-355-8940.

Your School Name *
Your answer
School Address *
Please include the full address of your school. This is for driving directions, so no PO boxes please.
Your answer
Main office phone number *
Your answer
Name and title of requestor *
Your name and title at the school
Your answer
Requestor phone number *
best number to contact you
Your answer
Requestor email address *
your email address
Your answer
How would you prefer we contact you?
First Choice Date *
Select your first choice date for the visit
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/
DD
/
YYYY
Second Choice Date
Select your second choice date for the visit
MM
/
DD
/
YYYY
Third Choice Date
Select your third choice date for the visit
MM
/
DD
/
YYYY
Location of Program(s) *
In which room or space at your school will the program(s) take place? Space requirements are listed on the Science on Wheels website. Note, we cannot move assembly programs from one space to another UNLESS you choose the "Two Different Assemblies" or "I need something different" options below. Moving an assembly to a new location for multiple sessions will require additional time and may incur additional charges. If you do not know the location yet, please say you don't know.
Your answer
Assembly Format *
Please select the type of schedule you are looking to reserve. If you want to combine short and long assembly lengths, you will select those options in the next section.
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