Hybrid Lab Registration Request Form
Thank you for requesting a Hybrid Lab!  Please complete ALL fields below.  After you click "submit", you will receive a call or email from an Engineering Tomorrow staff member within 1-3 days to review your Hybrid Lab schedule, discuss program logistics (inc. distribution of student kits) and answer any questions you may have.  If you need help completing this form, please email contact@engineeringtomorrow.org for support.
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Preferred email address *
Best contact phone number *
Name of school
Full School Address (to mail kits) *
Hybrid lab topic you are interested in scheduling with Engineering tomorrow *
Required
Please select your preferred hybrid lab week: *
Captionless Image
Number of student kits requested : *
Please provide any additional comments or information below:
Disclaimer:  These kits are being provided to you and your students free of charge.  By accepting these kits, you acknowledge that they are being provided on an AS IS basis and that all warranties of any kind, express or implied, are hereby disclaimed.  The kits contain household materials that may be hazardous if not used in accordance with the Engineering Tomorrow lab instructions and should be kept away from small children.  Neither Engineering Tomorrow nor any of its employees, volunteers, or affiliates shall be liable for any personal injury, property damage or any other damages of any nature whatsoever sustained as a result of any use or misuse of any of the materials in the kits. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Engineering Tomorrow. Report Abuse
Google Forms