Exploring Energy

Presented by The IPAA/PESA Energy Education Center

Name of School*
Name of school district*
Which day will you be attending?*
- Tuesday, October 20
- Wednesday, October 21
Primary contact info:
Primary contact first and last name*
Primary contact job title*
Primary contact email*
Primary contact phone number*
How many students will be attending?*
How many chaperones will be attending?*
Total number of students and chaperones?
Will primary contact be on the bus with the students?*
- Yes
- No
If no, please give us the contact information of the person who will be on the bus.
Bus contact (if not primary contact)
How many in your group are vegetarian?*
Please plan on bringing a sack lunch if you or any of your student’s dietary restrictions are beyond vegetarian.