Qualtrics Survey | Qualtrics Experience Management

Thank you for your interest in Science On a Sphere (SOS)!

Please note that this activity is self-hosted. The ISNW will provide a staff member to operate the technology, however, the teacher is responsible for planning and presenting the lesson.

Please answer the following questions so that we can process your request.

Please provide the following contact information:

Your first and last name

School where you work

Email address

School Phone Number

Cell Number

Please indicate the date/time that you would like to visit SOS.

NOTE: Due to space constraints and staffing availability, we may be unable to accommodate your request. We recommend that you provide three options.

Please indicate the date/time that you would like to visit SOS.

NOTE: Due to space constraints and staffing availability, we may be unable to accommodate your request. We recommend that you provide three options.
	Requested Date of Visit	Requested Time of Visit
First Choice	First Choice	Second Choice
Second Choice	First Choice	Second Choice
Third Choice	First Choice	Second Choice

What is the number of student participants in your group? NOTE: The maximum program capacity (including chaperones) is 36.

What is the number of chaperones that will be accompanying your group? NOTE: There must be at least one chaperone for every 12 students.

What is the grade level of your group?

Elementary School Level
Middle School Level
High School Level
Mixed Grade Levels

Please list the visualizations that you would like to use, in the order you intend to use them.

You can browse and preview data visualizations here: https://sos.noaa.gov/catalog/datasets/

Have you previously participated in a SOS activity?

Yes
No