Reservation Form
* indicates a required field
*School Name:  
*City:   *State:   *Zip:  
*County:   *District:  
Teacher/Mission Information
*Teacher's Name:   *Phone:  
*Email:   *Good time to contact teacher:  
*e-Lab Choice:  
*Grade Level(s):   *Number of students:  
*Preferred Mission Schedule: (please provide first two choices below)
*1st choice   Date:   *Time:  
*2nd choice  Date:   *Time:  
Electricity Chemical Reactions
Matter Matters DNA
Seasons Science Magic
Volcanoes Electromagnetic Spectrum
Kitchen Chemistry Newton's Law I
Newton's Law II Newton's Law III

Invoicing Information
Send invoice to:  
Attn:   Email:  
Address:   City:  
State:   Zip:  

Technical Information
Technology Coordinator:   Phone:  
Email:   Good time to contact:  

Please indicate how you will be connecting with the Challenger Learning Center
IP with Video Conferencing Equipment:  
IP with Computer & Webcam, (SKYPE, Google Hangouts, etc):