Virtual Science Live Request Form
Thank you for your interest in a virtual science class with the Friends of the Domes!
For information, please visit
INFORMATION ABOUT YOUR GROUP:
School Group / Classroom
Home School Group
Group Leader/Teacher's Name
Group Leader's Cell Phone
Group Leader's Work (or Other) Phone
Group Leaders Email(s)
Please include all adults who are attending, or who should be included in email communication, separated by commas
Administrator Email (To Send Invoice)
Grade Level(s) of Children/Youth Attending
Preferred Delivery Method:
Zoom Video Chat
Google Meets Video Chat
Number of Children:
1 to 15 students
16 to 32 students
Would you like to apply for a scholarship to cover the cost of your experience?
We currently have grant funding available for virtual programs. Qualification is based on the DPI School Report Card - Student Groups - Percentage of Economically Disadvantaged Students. If you choose "Yes", an FOD staff member will be in contact with you via email within the week. Please note - if you've already been contact that you've been awarded a scholarship, you may leave this question blank.
Yes - full scholarship
Yes - partial scholarship
Any specific learning or accessibility needs for this virtual workshop?
Program Experience Choice
Pollinators, Unite!: Meet Honey B. as she explains the diversity and importance of pollinators
From Sun to Sugar: photosynthesis and how energy moves through food chains
The Science of Magic: A fun way to explain and test the scientific method
We are interested in something else (FOD will see if we can accommodate your request)
Your learning objectives for this experience (if any):
Any additional comments regarding programming or curriculum preferences?
Day of the Week Preferences
Check the day(s) that would work for your a field trip
Morning or Afternoon Preference?
Please note that the Domes are typically less busy in the morning
Important Time Considerations
I.e. times that definitely would work or would not work.
Specific Dates You Are Interested In Scheduling:
Please list dates separated by commas, in order of preference. Note: we may not be able to accommodate specific requests. Programs available after 5/24/21
Is there anything else you would like us to know?
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