Classroom STEAM Activity Kit Request Form
Please complete this brief form to reserve your STEAM Activity Kits! Kits must be picked up at the Women for a Healthy Environment office. Kits take up to 5-10 days to be created and delivered once a submission is received. Delivery can be arranged if within 10 miles of the city of Pittsburgh.
What is your name? *
Email Address *
What school (include school district if applicable) or organization do you work for? *
How many kits are you requesting? Each kit contains materials that can be shared between pairs or individual students. *
What grade are the students for whom you are requesting activity kits? *
Which kit are you requesting? (maximum of 2 choices per submission) *
Required
Would you prefer bulk packaging (ingredients not pre-measured, less plastic and packaging waste) or individual packaging (pre-measured materials for individual or student pairs, more plastic and packaging waste)? *
Would you like a lesson plan included with the kits? *
Would you like WHE staff to co-teach or lead a lesson with your students using the activity kits? This is a free service. *
When would you like the kits by? *
MM
/
DD
/
YYYY
Are you able to pick up the kits at our offices in the East Liberty neighborhood of Pittsburgh? *
Do you have other information or questions for staff?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms