Student Workshop Request Form
Thank you for expressing an interest in our student programs. All student workshops are FREE and will be conducted at the NASA IV&V ERC for a duration of 4-5 hours. These workshops have a capacity of no more than 18 students. Teachers will be responsible for the transportation of students and lunch. Please answer the following question in order to begin the process for planning the desired workshop/s. Once this form has been submitted, a representative from the Educator Resource Center (ERC) will contact you to finalize the workshop date and details. Thank you!

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Contact Name *
With whom will we be communicating to arrange the workshop/s?
Phone Number
E-mail Address
Contact Preference *
Select County *
Where are you located?
Workshop Title *
Which workshop/s are you requesting? (Select all that apply)
Participant Count *
How many students will be attending the workshop? (Capacity of 24 students)
Suggested Dates *
Please list 3 or 4 possible dates that you have in mind.
Workshop Schedule *
Please select a suggested start time. (Select all that apply)
Additional Information
Please describe any extra information or ask any questions that may be useful in providing a successful workshop experience. Example: I have a student who hasn't completed a photo release form.
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