National Science Center

Request a Van Visit

Site Contact Information
Contact Name:*
Title/Position:*
Work Phone Number:*
Cell Phone Number:
Email Address:*
Showsite Information
School Name:*
Street Address:*
City:*
State:*
Zip/Postal Code:*
Mailing Address (if different from above):
City:
State:
Zip:
Number of Students participating: (Programs are designed for 4th-9th grade)
Grades participating (4th through 9th grades only)
Has our van visited your school?:
If yes to the above question, what year?:
Are you willing to have media coverage?	(If you wish to have media coverage; please provide media outlet.)
Media/Additional Comments:

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Program Manager Contact Information
Name:	Mobile Discovery Centers ATZH-NSC, Building TNG-02 Fort Gordon, GA 30905
Phone:	(706) 791-9435 or (800) 325-5445
Email:	mdc@nscdiscovery.org