JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Play Like a Miner Prize Form
Enter your information to receive an ore cart prize and other goodies in the mail!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Your Name
*
Your answer
Email Address
*
Your answer
Mailing Address
*
Your answer
What was your favorite activity?
Your answer
What was your least favorite activity?
Your answer
What was the most interesting thing you learned from the Play Like a Miner videos?
Your answer
What would you like to learn more about?
Your answer
Code Word #1
*
Your answer
Code Word #2
*
Your answer
Bonus Code Word #3
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of UC Berkeley.
Report Abuse
Forms
