Enroll your class or group in our workshops


School Name


City Province Postal Code

Principal Name     School District

Age Group Elementary     Middle     Secondary     PreSchool     University     Adult     Senior    

Class Grade(s) P     K     1     2     3     4     5     6     7     8     9     10     11     12     Others    

Number of Students

Teacher's Information

First Name Last Name


Phone Cell Phone

Have you previously attended SFU science outreach activities? Yes     No     (If yes, list them in the comments)

How did you did you hear about SFU Science Outreach?(please check all that apply)
 School Principal     Professional Association     Parent     Email     Website     Social media (Facebook,Twitter, etc)     News stories in newspaper/radio/television     Signs, brochures     Advertisement in newspaper/radio/television     Family, friend or colleague     SFU employee     Other    

If other, or a website or media site, please specify the source:

What is your primary reason for bringing your students to this activity?
 Provide science role models     Talk about careers in science     Provide students with exposure to "real" science     Help teach the subject matter     Access specialized facilities and equipment     Have a high quality field trip to a university     Other    - please specify in the comments.

Please identify your top three choices of programs

Intended length of the session (in mins):

1st Preferred Date: (dd/mm/yyyy)

2nd Preferred Date: (dd/mm/yyyy)

3rd Preferred Date: (dd/mm/yyyy)

4th Preferred Date: (dd/mm/yyyy)

Do you prefer an in-person activity (either Burnaby or Surrey campus) or a virtual workshop or both? In-person     Virtual     Both    

  For virtual workshop(s) 

Do you prefer Teams or Zoom? Teams     Zoom    

Will students be able to hear or see us? Yes     No    

Are we able to hear or see the students? Yes     No    

Do students have access to mobile devices for virtual interactive activities (ie. Kahoot)? Yes     No    

Comments. To better tailor the program for providing a new and engaging experience, please describe the activities you are currently doing in your own classroom.

Curriculum and topics covered. Describe the depth of the topics covered in class or to provide other information you want us to know.

This information is collected under the authority of the University Act [RSBC 1996 c.468 s. 27(4)(a)] and is needed by the University to operate the Science Outreach program. If you have any questions about the collection and use of this information please contact the Science Outreach Coordinator at sfuscienceoutreach@sfu.ca.