S.T.E.M. Apply for a S.T.E.M. Field Trip Name Email Name of School or Business Street Address City / State / Zip Please list the best contact phone number for you Organization's Primary Phone number Please select the option which best describes you Choose an Answer Administrator Teacher Parent What best describes your group? Choose an Answer Public Private Public Title One Charter Montessori Homeschool Other Please provide your non-profit certification number What grade level(s) will be participating in the field trip? Do you want an in person field trip or virtual experience? Choose an Answer In person Virtual What lesson plan are you interested in our educator teaching? Choose an Answer The Science of Roller Formulas, Fraction and Fun Motion & Skate Design Newton's Law of Motion Music, Math & Roller Skating The Science Behind Roller and Ice Hockey Super Sound! Acoustics & Rink Design Arcade STEM Science of Lighting Heart, Health and Fitness Virtual Only - Football, Soccer, Roller Staking and Roller Derby What date would you prefer for your event? Please list at least 3 available dates for your field trip. We will do our best to accommodate you. How many students are you planning on bringing? How many chaperones are you planning on bringing? How did you hear about our S.T.E.M program at Skate World? What three hour time period would you prefer for your event? Typically because of bus transportation, the earliest arrival is 9:30am. If you can only do 2-2.5 hours, we can adjust our schedule to accommodate your needs. For example, please type 9:30am-12:30pm or 9:45am-12:15pm Would you be interested in having cheese pizza and drinks for lunch after the STEM lesson? We have an amazing deal with fresh pizza for our school groups! 1 slice/1 drink =$4 OR Unlimited pizza and drinks $7 per student. Choose an Answer $7 Unlimited pizza / drinks $4 One slice / one drink No food Please give us the email address for the person handling accounts payable at your school. We encourage students to bring spending money to use in our new arcade and extra snack options. Some children enjoy just being in the atmosphere without skating and would love for them to have the opportunity to fully enjoy themselves. Are you allowing your students to bring money to spend? Choose An Answer YES NO Please give us the email addresses for all teachers participating in the field trip. Any additional comments? Send