Ruth Patrick Science Education Center
2015 SUMMER PROGRAMS RESERVATION REQUEST
Completed forms may be emailed to [email protected]; or mailed to RPSEC, Box 3, USC Aiken, 471 University Parkway, Aiken, South
Carolina 29801; or faxed to 803-641-3615. You can find this form and other information at: http://rpsec.usca.edu/summer/. You may also call
us at (803) 641-3313.
PROGRAM REQUEST GUIDELINES
• We suggest groups combine 2 or 3 programs in one visit.
• We require a minimum of 10 students.
o Groups between 10 and 30 students may select one, two, or three
programs per visit. Programs are one hour long.
o Groups of 31 to 60 students must select two (2) or three (3)
programs per visit. Students will rotate through the programs,
requiring a minimum visit of 2½ hours. Only one program may be a
planetarium program.
o Groups of 61 to 90 students should schedule three (3) programs for
a total visit of 3½ to 4 hours including time for lunch. Please select
one planetarium program plus two discovery.
PAYMET IS DUE UPON ARRIVAL.
Please make checks payable to USCA.
RPSEC SUMMER PROGRAM FEES
1 Program (1 hour) = $4.00 per student
2 Programs (1 hour each) = $7.00 per student
3 Programs (1 hour each) = $10.00 per student
Planetarium Restrictions: One group leader is admitted free; one chaperone per
eight students is also admitted free. Additional chaperones pay $4.00 each.
TO FINALIZE YOUR RESERVATION:
Request forms should be submitted at least two (2) weeks in
advance. After you submit a reservation request, you will receive a
confirmation letter with details about your scheduled visit. Signed
confirmation letters must be returned one (1) week prior to your
visit.
Restrictions: Children under four (4) years of age are not permitted in many of our student programs. Please see the age guidelines on our
program descriptions sheet. For planetarium shows, you can help our stars shine brightly by leaving any light-up shoes or clothing at home.
ADA Statement: Please indicate if you need any special services, assistance, or accommodations to participate in our programs by
contacting us in advance at [email protected] or (803) 641-3313.
Teacher’s Name: _______________________________________________
Home Phone: __________________________
Home Address:
Birthdate (mm/dd): _________________________
Cell Phone: _____________________ Last four digits of SS#: _____________
___________________________________ City, State, Zip: __________________________________________
School/Org.: ______________________________________
Age of Students: _________________________________
School/Org. Phone: ____________________________________ Email Address: _________________________________________ E-mail A
Number of students: (10 minimum, 90 maximum) _______ Number of programs requested (1, 2, or 3): _______________________
Name(s) of other teacher(s) who will attend: _____________________________________________________________________
PROGRAM REQUESTS:
Please list your requests in priority order. We suggest you combine 2 or 3 programs in one visit.
First Choice Program(s)
Second Choice
Third Choice
Month: _____________________________
Month: _______________________________
Month: _____________________________
A. _________________________________
A. ___________________________________
A. _________________________________
B. _________________________________
B. ___________________________________
B. _________________________________
C. _________________________________
C. ___________________________________
C. _________________________________
Programs are generally offered on Tuesdays, Wednesdays and Thursdays
Check ANY days of the week that you CAN visit: ___ Tuesday ___ Wednesday ___ Thursday
Check ANY of the times that you CAN start a program: ___ 9:15 AM ___10:30 AM ___ 12:00 PM ___ 1:15 PM ___ 2:30PM
If you prefer a specific date and time, please list: Not Guaranteed
OFFICE USE ONLY:
COMMENTS:
PRINT for your records or to mail
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