Eau de Space STEM Program Partnership (EdS-STEM Partner) Signup Form

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Eau de Space's mission is to globally impact K-12 STEM programs, increasing excitement for Science, Technology, Engineering, and Math through experiential education. To signup as a partner and receive free samples for your STEM program you must be:

1. Employed or strongly affiliated with a School, Education based non-profit, Youth Group, Summer Camp, STEM program, or similarly oriented business. This is to make sure that our samples go to programs that will use them and the person who receives them is the person who will educate, or facilitate the education of, students.
2. Request a scholarship award for your program based on financial need or merit.
3. Fill out the form below fully, including describing the total projected number of students that will be impacted and agree to share teaching resources with your EdS STEM Program peers.
4. Agree to administer Eau de Space Fragrance in a responsible manner and to maintain full supervision and to take full responsibility of the use of any products that Eau de Space provides to you.

Please note, all approvals remain at the full discretion of Eau de Space and the partnership can be terminated at any time at the sole discretion of the Eau de Space team with no notification or explanation required. You also agree to indemnify, and hold harmless, Eau de Space from any damages, negligence, or willful misconduct. The terms and conditions may change at any time and without notice. It is your responsibility to check this page regularly and withdraw from the contract at any time by notifying Eau de Space 60 days before termination.

Email *

Name of your school or Program

Are you Employed or strongly affiliated with a School, Education based non-profit, Youth Group, Summer Camp, STEM program, or similarly oriented business. This is to make sure that our samples go to programs that will use them and the person who receives them is the person who will educate, or facilitate the education of, students.

Yes

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What is your Name?

What is your role at your organization?

Where are you located?

What is the focus of your Program?

Projected number of students you will be able to impact?

Why is Eau de Space a good fit for your STEM program?

Do you agree to act as a hub for other STEM programs, sharing excess Eau de Space, as well as educational materials, homework, reading material, lesson plans, with other schools upon their request?

Yes

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Are you requesting a financial grant for your samples of Eau de Space based on financial need or magnitude of STEM impact?

Financial Need

We will impact a large amount of students

Our program is not requesting financial support

Other:

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Do you grant us permission to post your contact information so that other schools in your area may contact you to access the above mentioned materials and any excess samples of Eau de Space that you program does not use?

Yes

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Would you be willing to send us an email update on how Eau de Space was received by your students? We're specifically interested on the impact that it had on your class, the reactions, and the conversations that resulted.

Yes

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Do you agree to indemnify, defend, and hold harmless the Eau de Space, and its partners, from and against any loss, cost, or damage of any kind (including reasonable outside attorneys’ fees) to the extent arising out of its breach of this Agreement, and/or its negligence or willful misconduct?

Yes

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Additional Information you would like to share

A copy of your responses will be emailed to the address you provided.

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