ROCKVILLE SCIENCE DAY 2009
Sunday, April 26, 2009, Noon to 5:00 p.m.
Set-up: Saturday, April 25, 4 to 6 p.m. & Sunday, April 26 10 a.m. to noon
Montgomery College, Rockville Campus

NAME (Organization or individual): ____________________________________________

NAME OF CONTACT PERSON: _____________________________________________

ADDRESS:________________________________________________________________

__________________________________________________________________________

PHONE # (Evening) _______________________  (Day) ___________________________

FAX: _________________________  E-MAIL: __________________________________

NAMES TO APPEAR ON THE
PROGRAM:_______________________________________________________________

TITLE OF YOUR EXHIBIT:

__________________________________________________________________________

TYPE OF EXHIBIT:      [_] Demonstration           [_] Hands-on            [_] Performance

DESCRIPTION: (Indicate the science involved, and the age groups of your target audience)

                         [_] 5 to 10 yrs                      [_] 11 to 20 yrs                 [_] Over 21 yrs 

SPACE NEEDED: (Tables are 6 ft X 2.5 ft)_____________________________________

DESCRIBE ANY SPECIAL NEEDS:    [_] Running water    [_] Drainage    [_] Electricity

PLEASE RETURN THIS FORM BY FEBRUARY 15, 2008 TO:
Bob Ekman, 524 Carr Ave, Rockville, MD 20850
or e-mail to bob.ekman@att.net
 

 For more information:  call Phyllis Marcuccio at 301-763-3588  
or go to:  www.rockvillescience.org