2015 SUMMER PROGRAMS RESERVATION REQUEST
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 RESET FORM _____ Database
© Copyright 2024