STEM Excursion Reservation Request Form (7-12)
* Required
The Center for Mathematics and Science Education (CMSE) at the University of Mississippi is excited to partner with teachers of grades 7-12 teachers to provide valuable learning experiences to students through a STEM Excursion! The purpose of this offering is to generate interest in and expose students in grades K-12 to STEM education and the University of Mississippi. Through this program, the CMSE provides coordination and logistical assistance to teachers by creating a day of STEM-focused opportunities while getting the most from the visit to campus.
Contact Information
First Name
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Your answer
Last Name
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Your answer
Preferred Email Address
*
This will be the email address that will be used to contact you.
Your answer
Any other email address(es) that should be cc'ed
Your answer
Cell Phone Number
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This number will ONLY be used for day of excursion, if needed. Please use this format: XXX-XXX-XXXX.
Your answer
School/Group Information
Your role at school/group
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(Classroom Teacher, Principal, Science Coordinator, etc)
Your answer
School/Group Name
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Your answer
School/Group District
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Your answer
School/Group Phone Number
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Please use this format: XXX-XXX-XXXX.
Your answer
School/Group Mailing Address
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Your answer
City
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Your answer
State
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MS
Other:
Zip Code
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Your answer
County
*
Your answer
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