Science on the Move

Spring 2008 Visit Request Form

This form represents your scheduling preferences for a one-time visit. Please select your 1st, 2nd, and 3rd choice to ensure flexibility due to any delay in updating the availability of specific dates.

For each additional visit please fill out a separate registration form.

Science on the Move is currently booked for the Spring 2008 semester. If you are interested in a visit during the Fall 2008 semester, please complete the information below so that it will be on file. You will be contacted when registration for the Fall 2008 semester begins. Thank you for your patience and I look forward to working with you soon.

Please enter the following information:
(* indicates required fields)

* Name:		* Email:
		* Confirm Email:

* School:
* School Address:
* City/State/Zip:
* Phone(w):
(h):
(other):

* Grade Level(s):
Planning Period Time:
Starting Time Of Visit:		EST CST
Ending Time Of Visit:
# Of Classes:
# Of Students Per Class:
* Type Of Visit:	Demo Show Student Lab Other
* Specific Activity Or General Topics To Be Addressed During Visit

Do you prefer to receive future correspondence by email or regular mail ?

If you have any problems, please feel free to contact:	Jonathon Grooms grooms@physics.fsu.edu 850-645-4966

Science on the Move - Physics Admin Office KEN 315 Tallahassee, FL 32306-4350 - 850-645-4966

Florida State University, Department of Biological Science Tallahassee, FL 32306
Phone: (850) 644-3700 Fax: (850) 644-9829
E-Mail: webmaster@bio.fsu.edu