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* 1. Name of Person Completing This Form

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* 2. Name of Library/School Library

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* 3. Where did you hold your Moon Rover Kit event?

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* 4. When did you hold your Moon Rover Kit event?

Date / Time

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* 5. What age group(s) participated in this Moon Rover Kit event?

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* 6. Were parents/caregivers invited to participate in the event?

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* 7. How many youth and/or adults actively participated in the Moon Rover Kit event?

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* 8. Please write a paragraph describing your Moon Rover Kit event. This should include a general overview, what worked, what didn't, and any insights or suggestions you have for future events! (If you would prefer to upload a file with your narrative, write "Uploaded" in the box below and upload your narrative file in Question #14, #15, or #16.)

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* 9. Please upload at least three photos from your Moon Rover Kit event. If faces are showing in the photo, please email photo releases to Jennifer Johnson (jennifer.johnson@vermont.gov) making sure to include the date of the event and the library name in your email. You may also email photos to Jennifer rather than uploading them here. If you have created an online album, you may share that link rather than uploading individual photos (see Question #13.) You may upload your first photo here.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File
No file chosen

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* 10. Photo Upload #2

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No file chosen

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* 11. Photo Upload #3

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* 12. Link to photo album of event

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* 13. Additional File Upload

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* 14. Additional File Upload

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
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* 15. Additional File Upload

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No file chosen

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* 16. Please share any additional comments, suggestions, concerns, etc. about your Moon Rover Kit event or the kits in general.

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* 17. May we contact you for further information about your event? If so, include your email address here.

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