Workshop Request Form - Hawaii

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Mad Science Kids Club


	Workshop Request Form

Fill out all the fields below and hit the "Submit" button. Completing this form does not obligate you to a Workshop on the day/time you are requesting. However, you will hear from Mad Science within 1 business day, and we will work our best to answer all your questions and fullfill all your needs!

What prompted you to visit our site today?

Your Name
Your School/Organization Name
School/Work Number
Other Number (specify)
Email Address
Grade/s Workshop is for
Event Date/s Requesting
# of children in class/es

WORKSHOP TOPICS:
Dinosaurs (K-2)	Black & Blue Oceans (3-6)
Seeking Our Senses (K-2)	Electricity (3-6)
Where's The Air? (K-2)	Mineral Mania (3-6)

Anything else we should know?


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