SOTM Visit Request

Welcome to the Visit Request Form for Science on the Move!

Please be aware that submitting a request is not a guarantee that you will receive outreach. Your outreach is not scheduled until you receive a confirmation email from Science on the Move. Visit requests are granted at the sole discretion of the program director based on a number of factors (e.g., date of last visit, date and activity availability, demonstrated need, past cooperation).

Please take your time completing the entire visit request form, reading the rules carefully, and putting some thought into your responses.

If you are part of a teaching team and/or multiple teachers from your school would like us to visit, please discuss this with your team, make sure everyone is on board, and choose ONE representative to file a request and run point.

Select Preferred Dates

Please select your first, second, and third choice of dates for a visit. The more options you provide, the more likely it is that we will be able to visit.

The calendars are interactive:

Click on a date to select it.
To switch months, use the arrows or month drop down menu.

First choice

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Second choice

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Third choice

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Contact Information

Primary Contact

Title (Mr, Ms, Dr etc.)

First Name

Last Name

Email

Phone

School Information

School/Organization Name

School Address

City/State/Zip

School Phone

Visit Information

Please note, this investigation requires access to power outlets.

Please include a description of the type of investigation you are interested in in the additional comments section. I will reach out directly and determine if I can create some curriculum.

Please note, this investigation requires access to ice.

Please note, this investigation requires access to a water supply, ice, and a power outlet.

Please note, this investigation requires access to a water supply.

Please note, this investigation requires access to a water supply and power outlet.

Number of Participants

Number of classes/sessions (max. 8)

TOTAL number of students across all classes/sessions (max. 25 students per class/session)

Number of Teachers

Visit Schedule

Time Zone

Select the time zone your school is in.

EST
CST

Class Schedule

Enter the times of the classes/sessions for the visit including any flexibility in the schedule. The more detail you can provide, the better.

Additionally, if you have block scheduling or are requesting a visit for a teaching team, would you like to discuss holding a visit on an additional day so that all your classes may participate? For example, if you are the liaison for a 4th grade teaching team and there are 8 sections of 4th grade at your school, on certain Monday/Tuesdays or Thursday/Fridays we could arrange two consecutive days of visits in which we see 4 classes each day. Again, the more detail you can provide about your needs and any flexibility in the schedule, the better. Please note, this is not guaranteed but we will work to accommodate this situation where possible.

Additional Comments

Is there anything we should know about your classes? For example, do your students have any special requirements or accommodations?

Your Expectations and Experience

Please take a moment to compose answers to the following free response questions so that we have a better idea of where you are coming from and what you expect.

Why did you choose the investigation you selected?

How long have you been a classroom teacher?

Have you had SOTM visit your classroom in the past?

Yes

No

Additional comments or questions?

Classroom Visit Agreement

Please check the following boxes to demonstrate you have read and understood the Classroom Visit Agreement.

Completion of this form does NOT guarantee you a visit this semester, but is a necessary condition for selection.

I understand that Science on the Move is a free program and as such is in very high demand, so I will make the most of this opportunity.
I recognize that the Science on the Move instructor is an expert in physical science content and pedagogical content knowledge and I view my visit from Science on the Move as a professional development opportunity for me as well as a learning experience for my students.
I will be present. I will schedule the visit for a day on which I will be with my class. I will not arrange for a substitute (except in cases of extreme emergency).
I will be engaged and will model good behavior for my students. I will not grade papers, leave the room, or otherwise disrupt class.
I will support student learning by maintaining control of my class without discouraging student thinking, expression of ideas, or discussion when appropriate.
I understand that state mandated class size limits apply. I respect that Science on the Move cannot accommodate more than 25 students at a time for safety reasons.
I understand that Science on the Move investigations are intended as classroom laboratory activities. I will aid in facilitation however I can by, including but not limited to, preparing a suitable schedule, reserving an appropriate classroom/field, obtaining any necessary approval from my school officials, and alerting Science on the Move staff of any special considerations.
If signing up on behalf of a teaching team, I will make my team aware of the stipulations of this agreement.
I recognize that failure to uphold this agreement may influence my priority for future Science on the Move classroom visit sign-ups and/or my equipment loan privileges.