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CSUDH CISE Fab Lab Request Form
Thank you for your interest in the CISE Mobile Fab Lab! In order to better assist you please tell us more about your event. We look forward to working with you!
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Full Name (First, Last)
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Your answer
Name of Organization or School District you represent.
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Your answer
Telephone Number
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Your answer
Email Address
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Your answer
Event Address
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Your answer
Event Start Date (Please submit requests a minimum of 30 days in advance.)
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MM
/
DD
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YYYY
What is the purpose of the Fab Lab for your event?
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STEAM Day (Introduction to Fabrication Technology)
Curriculum-aligned Session (One Day)
Curriculum-aligned Sessions (Multi-Day)
Curriculum-aligned Sessions (Virtual STEAM Week)
Fab Lab Fabrication Technology Professional Development Series
Parent Workshop
Project-based Learning Professional Development (Must combine with a STEAM week that is led by participating teachers)
Other:
Required
Event Duration
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One Day
Two Consecutive Days
Three Consecutive Days
Four Consecutive Days
Full week
Other:
Who is the intended audience for this event?
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K-2 Grade Level (Lower Elementary School) Students
3-5 Grade Level (Higher Elementary School) Students
6-8 Grade Level (Middle School) Students
9-12 Grade Level (High School) Students
Higher Education (Community College or University) Students
K-12 Educators
Parents
General Public
Other:
How many participants will be in attendance?
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Your answer
How did you hear about our Mobile Fab Labs?
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Your answer
If you have any other questions or comments please add them below.
Your answer
Thank you for your request. Please allow up to 48 hours for a response.
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