K-12 Academic Outreach

School Name(Required)

School Address(Required)

Street

City

State

Zip

Name(Required)

First

Last

Phone(Required)

Email(Required)

School phone

What is the event type?

If you are requesting an Enrichment Talk, please refer to our catalog and indicate your choices below.

NSA K-12 Outreach Catalog

1st Choice:

Alternate:

If you selected STEM/Language Judging:

How many judges are needed:

Estimated number of student projects:

Specific expertise required?

Is the event Virtual or In-person?

Virtual
In-Person

Grade Level(s)(Required)

Event date and time

Or desired date range

Please fill-out ths section if your event is Virtual; otherwise, skip to the In-Person section

Number of Virtual sessions

Average number of students per Virtual session

What is the platform (e.g. Google Meet, Zoom, MS Teams)?

Does the platform allow guest or co-host access?

Yes
No

Number of classes/groups

Average number of students per class/group

What is the event format?

Classroom
Panel
Information Table
Other

Please specify details in additional information section below

List any special requirements for visitors

Additional event information (Virtual and In-Person):

Include information to help with event planning (e.g specific career day focus, number of panel members requested, at/below grade level).

Specify other

K-12 Academic Outreach

School Information:

Requester Information:

Event

Virtual Event Information:

In-person event information:

Additional event information (Virtual and In-Person):

How did you hear about us?

NSA Resources

External Resources

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