Out Of Hours Care - Book After School Science

About Your Organisation
Organisation Address * Required
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Venue Address (If different to above)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

About Your Scitech Visit
Date Preference 1 - must be dd/mm/yyyy format * Required
DD slash MM slash YYYY
Date Preference 2 - must be dd/mm/yyyy format * Required
DD slash MM slash YYYY
Date Preference 3 - must be dd/mm/yyyy format * Required
DD slash MM slash YYYY
Preferred start time of visit * Required
Estimated number of participants * Required
Do any of the participants have special needs? * Required
- Yes
- No
Please provide detail about your participants' special needs and if there is anything Scitech can do to best accommodate their needs (e.g. ear protection etc.)
Which activities would you like at the Out of School Care? * Required
- Science Shows only (4 to 12 year olds)
- Science Shows and Workshops (4 to 12 year olds)
- Spacedome Shows and Workshops (4 to 12 year olds)
- Please contact me to discuss program options

Additional Information
Extra comments
Please provide any relevant information for the Scitech Customer Service Team regarding your visit e.g. parking directions, multiple venues, specific experiences advertised on our website.
How did you find out about Scitech's programs?
- Social media
- Recommended/Word of mouth
- Playgroup WA
- Previous visit
- Professional Learning Workshop
- Flyer
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Email
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