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* 1. Please provide your full name.

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* 3. Please provide your contact number.

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* 4. What is the name of your school or educational institution?

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* 5. What grade levels are your students in?

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* 6. Are there any specific topics or activities in neuroscience that you would like to be included in the curriculum?

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* 7. How many students will be participating in the neuroscience curriculum? (per class)

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* 8. How long (time duration) do you want the workshops to be? (ex: 45 minutes 3 times a week)

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* 9. How many students will be participating in the neuroscience curriculum? (per class)

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* 10. Do your students have any special needs or considerations that we should be aware of?

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