Interactive Programs Registration Form

Fill out the form below for interactive labs, field trips or expert chats facilitated by the FIU CASE Education Outreach team.

Name of Organization
Which of the following best describes your organization?

Which of the following best describes your organization? Elementary School Middle/High School Scout Troop/Pack Higher Education Library Other Other
What is the grade level/age of participants?

What is the grade level/age of participants? K-2nd Grade 3rd-5th Grade 6th-8th Grade 9th-12th Grade College Level Family Adults of Mixed Ages
Number of anticipated participants.
(Please note many interactive programs have a maximum particpant limit.)
Contact Name Contact Name First Last
Contact Phone Number Contact Phone Number - ### - ### ####
Contact Email
Organization Address Organization Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Program Information

Please provide information on the type of program you are interested in.

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. For in person opportunities, the price includes travel up to 30 miles one-way from the FIU MMC or BBC campuses. Additional travel costs may be applied to trips outside this range.

Which kind of program are you interested in?

Program Information

Please provide information on the type of program you are interested in.

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. For in person opportunities, the price includes travel up to 30 miles one-way from the FIU MMC or BBC campuses. Additional travel costs may be applied to trips outside this range.

Which kind of program are you interested in? In-Person Virtual
INTERACTIVE LABS

Please choose the INTERACTIVE LAB program(s) you are interested in. If you are not interested in one of these programs, skip this step.

- Programs are 45-60 minutes in length.
- Programs are for 30 participants max.
- In-person: $250 for the first session and 10% off each additional.
- Virtual: $200 for the first session and 10% off each additional.

Interactive Lab #1
How many of this program would you like to schedule?

How many of this program would you like to schedule? 1 2 3 4 5
Interactive Lab #2
How many of this program would you like to schedule?

How many of this program would you like to schedule? 1 2 3 4 5
FIELD TRIPS

Please choose the FIELD TRIP program you are interested in. If you are not interested in one of these programs, skip this step.

- Programs are 2 hours in length.
- Programs are for 30 participants max.
- In-person: $400
- Virtual: $365
MEET AN EXPERT

Please choose the MEET AN EXPERT theme you are interested in. If you are not interested in one of these programs, skip this step.

- Programs are 1 hour in length.
- Programs are for 30 participants max.
- Once theme is chosen, someone from our team will contact you with potential speakers.
- In-person: $450
- Virtual: $400

Research Topic
FIU STEAM FESTIVAL

This is a family science night hosted by FIU CASE at your school or organization. If you are not interested in one of these programs, skip this step.

- Program is 2 hours in length.
- Program is for 200 participants max.
- In-person: $1,450
- Virtual: $1000

I am interested in registering for an FIU STEAM Festival.

FIU STEAM FESTIVAL

This is a family science night hosted by FIU CASE at your school or organization. If you are not interested in one of these programs, skip this step.

- Program is 2 hours in length.
- Program is for 200 participants max.
- In-person: $1,450
- Virtual: $1000

I am interested in registering for an FIU STEAM Festival. Yes - In-Person Yes-Virtual
Dates & Times

Please fill out the following information in regards to the availability your organization has for programming. Please provide 3 options for dates that would work for you. Dates & Times

Please fill out the following information in regards to the availability your organization has for programming. Please provide 3 options for dates that would work for you. / MM / DD YYYY
Date Date / MM / DD YYYY
Date Date / MM / DD YYYY
Please indicate the preferred time for your program. Please indicate the preferred time for your program. : HH MM AM/PM
How did you hear about our programs?

How did you hear about our programs? Social Media Website Newsletter Word of Mouth Other Other
Is there anything you would like to share with us before we begin the registration process?
Submit!

Once we receive your reservation, our team will review and process within 24 hours.

- Before your invoice is submitted, a team member will reach out to you to discuss the desired programming.
- Electronic credit card payments are accepted (with a 3% processing fee). Checks are also accepted.
- A $50 deposit is required to secure your program date.
- The remainder of your payment must be received 7 business days prior to the facilitation of your event date.
-For inquiries, please contact Caseoutreach@fiu.edu