School InformationTeacher Name* First Last Teacher Email Address* Student Name* First Last School NameSchool Address Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code School PhoneSchool DistrictHow many students attend your school?What percentage of students at your school receive free/reduced lunch?How did you hear about Oklahoma Science Adventure?*---Sam Noble Museum WebsiteSam Noble Museum EmailSam Noble Museum Events CalendarSocial MediaMagazine ArticleNewspaper ArticleRadioPreviously ReservedWhile at Museum: Event/ProgramA FlierBooth at Outreach EventEducation Colleague or Professional DevelopmentStudent InformationWhat grade(s) and subject(s) do you teach, and in which class(es) have you had this student?*Does your school have a science club or other extra-curricular science opportunities? If so, please describe. Is this student involved in these opportunities?*Tell us a little about this student. Please reference their interest and enthusiasm for science.*Please provide us with your candid opinion of the student’s social, intellectual and personal capabilities. Please reference: personal integrity, academic ability, self-confidence, work habits, and teamwork skills.*Students will be working with peers and scientists. What strengths does this student possess that will make him/her a good team member?*Indicate strength of overall endorsement:*---Not RecommendedRecommended with ReservationRecommendedHighly RecommendedApplication Agreement* I agree to the following. Show Full AgreementI certify that to my knowledge that the information in this application has been completed accurately and honestly.CAPTCHA