Registration Form for Water Education Programs

Sign up for stimulating in-class visits and field studies with local water experts-designed to meet learning levels and district standards for each grade.

Please fill in all the applicable information in the form below. Click the "Submit" button at the bottom to e-mail your request to us. The "Reset" button will clear all you have typed so you can start over.

We are currently booked for spring 2011 programs, and are taking requests for summer and fall. We apologize for any inconvenience.

We look forward to working with you soon!  

  Ms.Mr.
First Name
Last Name
School or Organization
Organization Type
Street Address/PO Box
City
State
Zip Code
Work Phone
Home Phone
E-mail
Best time to contact you
Preferred method of contact E-mail  Telephone  Regular Mail
Age of participants
Preschool 7th Grade
Kindergarten 8th Grade
1st Grade 9th Grade
2nd Grade 10th Grade
3rd Grade 11th Grade
4th Grade 12th Grade
5th Grade College
6th Grade Adults
Number of participants
Desired date of program
Desired start time
Desired end time
Course of Interest
Program topic (see list)
Preferred meeting place
Any additional information
Return to KICP Education Programs Page