Please use this form when requesting materials through our WOW! on Wheels flight.

WOW! on Wheels allows teachers to:
1. borrow materials needed to present WOW! lessons themselves. This is key when volunteer scheduling isn’t possible.

2. borrow STEM items for classroom use. We have beakers and graduated cylinders, microscopes and magnifying glasses, K'Nex kits, periodic table tiles, Tech devices and much, much more.

Materials can be delivered to your school, and we will pick them up when you’re finished.
- Deliveries are limited to within a 35-mile radius of WPAFB.
- Teachers outside of the 35-mile radius can meet a WOW! representative near WPAFB to borrow materials.

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* 1. Per Air Force and federal policy, our programs cannot use federal funds to provide resources, materials, and equipment to non-federal entities that charge a registration or admission fee.
Please confirm that you are requesting use of our program for a school classroom, or after-school program, that does not charge any kind of participation fee.

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* 2. Name :

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* 3. What is your role within the school?

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* 4. Email address:

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* 5. School District:
We've tried to list as many options as we could. If you don't see your school district below, please provide information in the box provided. We would still love to work with you!

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* 6. School Building:

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* 7. School Address and Phone Number:
Missing information may cause a delay.

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* 8. Teacher's cell phone number (optional):

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* 9. How many teachers will be using these WOW! materials.

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* 10. If requesting for multiple teachers, is there one teacher that should be the point of contact for email communication, or should all teachers be involved in scheduling?

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* 11. To help us track participation, please list the names of all teachers who will be using the WOW! materials, even if you are serving as the primary point of contact.
Missing information may cause a delay.

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* 12. To help us track participation, please provide the email address for each teacher listed above who will be using the WOW! materials, even if you are serving as the primary point of contact.
Missing information may cause a delay.

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* 13. With WOW! on Wheels you can borrow:
- a complete WOW! lesson with a copy of our WOW! lesson plan and all materials needed
- any of our STEM materials for your own lesson

Please request at least 3-4 weeks in advance.
- All scheduling is based on availability of supplies.
- Materials will be delivered on Tuesday and picked up on Thursday of the following week.
- Adjustments can be made.
- The operational radius of WOW! on Wheels is 35 miles from WPAFB.

What would you like to request today?
(Please, only one option per request.)

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* 14. If requesting a lesson...
Have you reviewed the lesson information on our website, including the description, list of activities, and (if available) overview video?
- This helps ensure the lesson matches your needs and expectations before materials are delivered.

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* 15. Grade level(s) that will be using these WOW! materials:

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* 16. Number of classes that will be using these WOW! materials:

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* 17. Total number of students that will be using these WOW! materials:
Please total all classes you are scheduling for.

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* 18. Total Number of Students that are from military families?

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* 19. Please request 3-4 weeks in advance.

Requested Delivery Date:
 - Materials are scheduled for a Tuesday delivery, with a pick-up on the following Thursday.
- If you need to request materials for longer than that time frame, please include this information below.

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* 20. What time does your school office open?
This helps us make sure our courier isn't stuck in drop-off traffic.

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* 21. What time does your school office close?
This helps us make sure our courier isn't stuck in dismissal traffic.

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* 22. Are there any specific directions I can give our courier?
(Which door to use? Where to park? How to avoid stairs? etc.)

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* 23. How long have you used the WOW! on Wheels program?

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* 24. Please rank the following reasons for requesting this WOW! lesson or WOW! materials in order of importance - 1 being the most important to you.

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* 25. Please check the boxes below to confirm that you are aware of this information.

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* 26. As the requesting teacher, I accept responsibility for the proper care of WOW! materials.

To help keep WOW! materials available for all classrooms, I agree to ensure that all borrowed materials are packed appropriately and returned to the WOW! program after use.

If other teachers use the materials, I understand that it is my responsibility to inspect the contents after the final use and confirm that all items are present and match the packing list prior to returning the bin.

I understand that it is my responsibility to report any missing or damaged items at the time of return.

For more information or if you have questions, contact Angel Callahan at 937-938-4868, or email at antointette.callahan.ctr@us.af.mil

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