Leap into Science Wind & Air Salem Application
Please fill out this form if you are interested in attending our Leap into Science training at Gilbert House Children's Museum on April 5th, 2019. The training is scheduled from 9am-1pm. This training will be focused on informal educators, providing guidance and time to practice the activities and facilitation strategies.

Participating Programs/Sites Will Receive:
Evidence-based curricula and kit of materials**
Professional development in how to lead Leap into Science workshops for young children and families
Network of informal educators who are committed to science and literacy
Ongoing technical support from our state leaders and national project team

**We have access to a limited number of kits and they are distributed as part of a national pilot with several key requirements. Please answer the questions below to the best of your ability to help us ensure requirements can be met if you would like a kit. If there are multiple people at the training from one organization, the expectation is that each kit will be used for 2 youth workshops and 1 family workshop.

Thank you for your interest in participating in this pilot and supporting the expansion of science and literacy opportunities throughout Oregon!

Your Name *
Your answer
Organization *
Your answer
Email *
Your answer
What county is your organization in? *
Your answer
Will you be able to bring another person from your organization? If yes, please include their name below *
Have you received a Leap into Science Kit of materials from the year 1 Balance workshop? *
Please let us know if you participated in this national pilot during the last year and received a kit.
Can your organization facilitate at least two 45 min. or longer workshops per year for children either 3-5 years old and/or 5-10 years old? *
The 45 minute workshops can also be broken up into shorter activity times if you plan to do multiple days but you will be expected to provide at least 45 minutes per 'workshop'.
Can your organization facilitate one hour long workshop with children, family and community? *
Can you lead an event during National Leap into Science Week (last week of February)that spreads the word about Leap into Science? *
We do not yet have strict guidelines on what this would entail but we would expect all trainees to participate in some way
Can you participate in quarterly calls for trained educators in Oregon? *
Can you complete brief online surveys after each event and at end of program year (Spring 2019)? *
If you answered no or maybe to any of the above, please describe why:
Your answer
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