Enroll your class or group in our workshops

School Name

Address

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      Number of Students

Teacher's Information

First Name    Last Name 

Email

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)

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

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.


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.