Science on Wheels Public Assembly or Starlab Program Registration Form
Please scroll down and fill out the form below to request a Science on Wheels public assembly or Starlab program visit from Roper Mountain Science Center. Our public programs are intended for public venues such as libraries, camps, Math and Science nights, and community events.

If you would like to request one of our school programs instead, please go to the website below and click the appropriate registration link there:

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

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.

Organization Name *
Your answer
Address *
Please include the full address where the program will take place. This will be used to get driving directions, so please do not use PO boxes.
Your answer
Organization phone number *
Your answer
Name and title of requestor *
Your name and title at the venue
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? *
Required
First Choice Date *
Select your first choice date for the visit.
MM
/
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 site will the program(s) take place? Please refer back to the public programs website for space requirements. Programs cannot be moved from one space to another once set up.
Your answer
Audience
Please tell us what kind of audience you are expecting for the program(s) (family groups, children, age groups, etc.) Our programs are best suited for ages 5 and up but can be adapted for a pre-school audience if requested.
Your answer
Program *
What program would you like to reserve?
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