Registration for PhysicsQuest 2012

Please email thompson@aps.org if you have special requests.

Note: Fields in RED are required

First Name 
Last Name 
Institution 
Address 1 
Address 2 
City 
State 
Zip 
Phone 
Email 

  Is the above address:     School    Home   
 
Number of participating classes per grade level (One kit will be sent per class)
6th   
7th   
8th   
9th   
Total   
 
Optional
How did you hear about PhysicsQuest?
   Conference/Workshop  Recommendation from another teacher
  PhysicsCentral.com  Mailing
  Participated last year  Other
   
 
With what type of group will you be doing PhysicQuest?
   Public School (no title 1 funding)
  Public School (title 1 funding)
  Home School
  Charter School
  After School Group
  Boyscout/Girlscout Troop
  Other      
 
In which past PhysicsQuests have you participated?
    Einstein's Hidden Treasure
    Benjamin Franklin's Secret Message
    Marie Curie's Floating Classes
    Nikola Tesla and the Electric Fair
    Spectra's Power
    Spectra's Force
    Spectra's Heats Up
 
   Would you like to receive other email updates from American Physical Society

  

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