K-12 Outreach School Partner Request Form

Name of School / Non-Profit (Required)

School Type (Required)

Public Private

County/District (Required)

School Address (Required)

Street

City

State

Zip

If your event takes place outside of our local area, our engagement with your students will be virtual, even if your students are meeting in-person. Please fill-out this section if your event is Virtual; otherwise, skip to the In-Person section

If your event takes place in an area where there is a local NSA presence, complete the information below. Otherwise, please complete the Virtual Event section above.

NOTE: If the CDC COVID Community Level for your school is high at the time of your event, NSA is limited to virtual engagements only.

Name (Required)

First

Last

Email (Required)

Phone (Required)

(Ongoing support from the same person)

(Local to NSA site / In-Person ONLY)

Number of students involved?

Describe support desired.

Include type of activity (i.e. robotics mentor; programming or engineering; help with STEM club, if you already have a partner in mind, please include their name here)

Event Date(Required)

Start Time(Required)

End Time(Required)

Time Zone(Required)

If this is in prep for a specific competition or event, please indicate date/time of event(s).

Is this your first engagement with NSA’s K-12 Outreach Program?

Yes
No

List any special requirements for visitors

Additional Comments

(Include information to help with event planning, e.g. class above/below/on grade level, specific career day focus, speaker/panel member expertise)

K-12 Outreach School Partner Request Form

Partnerships are only available to schools local to an NSA site.

Education Institution Information

Requester Information

School Partner Information

Additional Information

How did you hear about us?

NSA.GOV

CULTURE

HELPFUL LINKS

RESOURCES

RELATED LINKS

K-12 Outreach School Partner Request Form

*Partnerships are only available to schools local to an NSA site.*

Education Institution Information

Requester Information

School Partner Information

Additional Information

How did you hear about us?

NSA.GOV

CULTURE

HELPFUL LINKS

RESOURCES

RELATED LINKS

Partnerships are only available to schools local to an NSA site.