Title of Activity/ Exhibit:

Organization Name:

Address:

City:

State:

Zip:

Phone:

()  

Website:

Passport Question:

Please provide a question that will be answered by your exhibit (appropriate for Grades 6-8).

Primary Contact Info:

Name:

Phone:

Email:

# of volunteers

Note:  Lunches provided for the # of volunteers listed here.

Exhibit Needs:

Tables

Water

Electricity

Other (please explain)

Focus and/or activities for exhibit: