CUNO classroom visit request
Columbia University Neuroscience Outreach is pleased to offer classroom visits by neuroscientists from September to January each year. This form is for teachers (or other school officials) who would like to request a visit from our scientist volunteers. For more information about CUNO and visits, please see our website, www.columbiabrains.org
Teacher and school info
First name
Your answer
Last name
Your answer
Position/title
Your answer
Email address
Type carefully!
Your answer
Phone number
(where you can be reached on the day of the visit if necessary)
Your answer
Name of school
Your answer
School adddress
Please note: Schools located in upper Mahnattan are given priority for visits. We regret we cannot visit all schools in New York City.!
Your answer
Reason for visit request
Please describe in 3-4 sentences why you are requesting the visit and how you think your students would benefit.
Your answer
Have you had a previous CUNO visit?
Request details
You can specify up to three dates for volunteers to visit. Generally CUNO lessons fill a single or double class period, and visits can include multiple classes (e.g. scientists visit all third grade classes in a school). If you request a visit to multiple classes, then please pick a day in which the class schedule for the visit would be relatively compact. In other words, the volunteers' time should be maximized in the classroom, not waiting around between classes.
Grade level(s) of class or group
We visit K-12 classrooms as well as after school groups
Your answer
Number of sections/classes to visit
For example, "3" = 3 class periods receiving the same material in one day. Sections can be at overlapping times
Your answer
Approximate number of students per section
Your answer
First choice date
Your answer
First choice time
Please enter the beginning and ending times, inclusive of all the sections or classes of the request. For example: "8:15-12:00" could encompass three 45-minute visits for classes starting at 8:15, 9:15, and 11:15 a.m.
Your answer
Does the first choice have overlapping sections?
In other words, would volunteers be visiting more than one room at a time?
Second choice date
Your answer
Second choice time
Your answer
Does the second choice have overlapping sections?
Third choice date
Your answer
Third choice time
Your answer
Does the third choice have overlapping sections?
Any additional comments?
Your answer
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Your email address will not be shared with other groups.
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