PhysicsQuest 2023: Making Waves Kit Request Form

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* 1. First Name

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* 2. Last Name

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* 3. Email

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* 4. Phone

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* 5. Organization

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* 6. Mailing address to school/institution/home
(at this time, we are not shipping to Alaska, Hawaii, or outside the United States)

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* 7. Is your institution a Title 1 school?

Yes

No

Not sure

This year’s kits come in classroom sets (fit for up to 30 students) or individual kits (fit for 1-4 students).

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* 8. How many classroom kits (for about 30 students) would you like to order (limit 4):

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* 9. How many individual kits (for 1-4 students) would you like to order (limit 5):

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* 10. I’m interested in receiving communication about other APS opportunities for school teachers and parents. This will give advance notice of PhysicsQuest kits next year.

Yes