Education Outreach Interactive Programs

1. CHOOSE YOUR PROGRAM FORMAT

1. CHOOSE YOUR PROGRAM FORMAT Virtual In Person
2. CHOOSE YOUR PROGRAM CATEGORY AND THEME

Options include interactive labs, our group demonstration, field trips and a family engagement program.

PLEASE NOTE:
This form is only to be used for a single day of programming. If you want to reserve programs on multiple days, a form must be filled-out for each individual day.
LABS

Each lab is 45 minutes. There are 6 different themes offered. Cost is $200 for the first session and a discounted $135 for each additional session of the same theme on the same day.

Choose your first lab:
How many sessions of this lab theme would you like to schedule?

How many sessions of this lab theme would you like to schedule? 1 2 3 4 5
If desired, choose your second lab theme here to be facilitated on the same day as your first lab theme.
How many sessions of your second chosen theme would you like on this same day?

How many sessions of your second chosen theme would you like on this same day? 1 2 3 4 5
If you would like more than two lab themes on the same day, please share your preferences here:
GROUP DEMONSTRATION

There is one theme offered. Cost is $265 for first and a discounted $210 for each additional group demo on the same if you want multiple.
Now that you've chosen your group demonstration, how many sessions would you like to schedule?

Now that you've chosen your group demonstration, how many sessions would you like to schedule? 1 2 3 4 5
FIELD TRIPS

There are 3 field trips offered on our Biscayne Bay Campus (BBC), Modesto Madique Campus (MMC) and various locations in the Florida Keys. Only one session can be reserved per day at a given location. The cost is $365.
FAMILY ENGAGEMENT

There is one family science night program offered. It is $865.
Preferred Date 1 Preferred Date 1 / MM / DD YYYY
Preferred Date 2 Preferred Date 2 / MM / DD YYYY
Preferred Date 3 Preferred Date 3 / MM / DD YYYY
Preferred Start Time
Please note, the earliest to reserve a virtual lab, group demonstration and field trips is 9am. Preferred Start Time
Please note, the earliest to reserve a virtual lab, group demonstration and field trips is 9am. : HH MM AM/PM
How many participants do you anticipate to be in each group?
What is the age demographic/school grade level of your participants?
To ensure that all participants can interact with and enjoy your organization, are there any special needs that we can endeavor to accommodate?
2. SHARE YOUR CONTACT INFORMATION
This will help us organize your virtual program(s).
Organization Name
Organization Address Organization Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Organization Phone Number Organization Phone Number - ### - ### ####
Contact Name
Contact Title/Role
Contact Phone Number Contact Phone Number - ### - ### ####
Contact Email Address
To the best of your knowledge, has CASE Education Outreach served your organization before?

To the best of your knowledge, has CASE Education Outreach served your organization before? Yes No
If you answered "yes" to the above question, please let us know what type of opportunity it was. This can include outreach programs and/or special events.
3. SUBMIT AND RECEIVE INVOICE
Once we receive your reservation, our CASE Education Outreach team will review and process within 24 hours. Before your invoice is submitted, a team member will call you to discuss this form. Electronic credit card payments are preferred but checks are also accepted. A $50 deposit to secure your program date is required. The remainder of your payment must be received 7 business days prior to the facilitation of your event date.

Education Outreach Interactive Programs

Education Outreach Interactive Programs

2. CHOOSE YOUR PROGRAM CATEGORY AND THEME

2. SHARE YOUR CONTACT INFORMATION This will help us organize your virtual program(s).

2. SHARE YOUR CONTACT INFORMATION
This will help us organize your virtual program(s).