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Pronoun

Title

First Name

Last Name

Phone Number

Personal Email

Some school districts have strong firewalls. Please include a personal e-mail as a backup.

Grade Level(s)

Number of Students

School Name

School Street Address

City

Province

Postal Code

What topics you would like the geologist to cover during the presentation?

Please list your top 3 topics in order of interest.

Preferred Date(s) and Time(s)

Please note that this workshop is 20- to 60-minutes long, and can be adapted to class schedules. Availability is subject to volunteer work schedules.

Comments

Please specify if you are looking for an in-person Geoscientist only.

AV Requirements

This program will require access to the internet and the ability to receive and transmit both audio and video.