Program Request Form

Program Request Form

What would you like to book today?

Please check all that apply
What type of group are you booking for?

If your group does not fit into any of these categories please call the Reservation Center at 860-520-2150. We are happy to help!

Organization Information

Organization Address
Organization Address
City
State/Province
Zip/Postal
Country
Grade Level

Your Information

Title
Name
Name
First
Last
What is your title?

Traveling Program Location Information

Will the program be taking place at the address you entered in the Organization Info section?
Program Location Address
Program Location Address
City
State/Province
Zip/Postal
Country

Traveling Program Logistics

What type of program would you like to book?
What grade(s) are you booking for?
Please select the grade band(s) that will be participating to view the program options.

Pre-K Programs


Price: $200 plus travel charges, $175 for the same program booked on the same day.
Capacity: Up to 16 participants per session.
Length: 30 minutes

We require tables and chairs, access to water and electricity, minimum of 10 minutes between sessions, and 15 to 30 minutes for set up and cleanup
Pre-K Programs

Classroom Program Options


Price: $295 plus travel charges, $250 for the same program booked on the same day.
Capacity: Up to 25 participants per session.
Length: 45 minutes

We require tables and chairs, access to water and electricity, minimum of 10 minutes between sessions, and 15 to 30 minutes for set up and cleanup
K-2 Programs
3-5 Programs
6-8 Programs
9-12 Programs

Exploration Program Options


Price: $295 plus travel charges, $250 for the same program booked on the same day.
Capacity: Up to 25 participants per session.
Length: 45 minutes

We require tables and chairs, access to water and electricity, minimum of 10 minutes between sessions, and 15 to 30 minutes for set up and cleanup
K-2 Programs
3-5 Programs
6-8 Programs

Assembly Shows


Price: $500 per show
Capacity: Available for groups of 100 to 250 participants
Length: 45 minutes

We require 6'of 8' free standing tables and access to water and electricity. Please allow 45 minutes for set up and breakdown of program materials.
Assembly Show Options
Is there a stage available?

Activity Stations


Price: $250 per station per hour

Ideal for larger events, Activity Stations are tabletop demonstrations and hands-on activities designed to engage groups of students or families in 5-10 minute walk up experiences. More than one station can be booked for an event. Please allow 45 minutes for set up and breakdown of program materials.
Which Activity Stations would you like to book?
Optional: $50 fee for take-home materials

Science at Home Kit Programs


Price:$475 per kit plus travel charges, $425 for 3 or more kits booked on the same day
Capacity:25 participants per kit
Length: 50 minutes
Science at Home Kit Programs

Virtual Program Logistics

Which video communication platform will you be using?
The Connecticut Science Center uses Zoom and Google Meet as their main video communication platforms. If you require use of another platform, we will follow up with you to discuss other options. STEM Career Showcases utilize a live YouTube stream in place of Google Meet and Zoom.
How will your students be participating in this program?

Virtual Program Options

What type of virtual program would you like to book?

Classroom & STEM Career Programming


Pricing: $200 per program
Capacity: Up to 25 students per program
Length: 45 minutes

Program Requirements:
• Computer to stream the live program
• WiFi connection
• Speakers & microphone capabilities (can be through a laptop, desktop, or webcam)
• Screen to share the computer with a larger audience (optional)
Teachers will be provided with student handouts — no additional materials are needed.
Classroom & STEM Career Programming

2022 STEM Career Showcase Dates:
• Friday, March 25, 2022
• Tuesday, May 3, 2022
• Friday, June 3, 2022
• Friday, November 4, 2022
• Tuesday, December 6, 2022

Enrichment Programming


Pricing: $200 per program
Capacity: Up to 25 students per program
Length: 45 minutes

Program Requirements:
• Computer to stream the live program
• WiFi connection
• Speakers & microphone capabilities (can be through a laptop, desktop, or webcam)
• Screen to share the computer with a larger audience (optional)
Enrichment Programming

Enrichment Kits

Our Science at Home Kit experience is now available for group bookings! Receive all of the materials needed for your entire classroom, youth group, or after-school program to participate in exciting hands-on science activities with the help of our STEM education team. Choose between a live, interactive, one-hour class or pre-recorded instructional video to follow along at your leisure, and upgrade your experience to Enrichment Kits Plus for enhanced materials and activities.

• One box serves up to 25 participants.
• Add-on materials can be purchased for an additional fee in increments of 10 participants.
• Recommended for participants ages 6-12.
• All the necessary supplies are included to complete all activities.
• Shipping (within the United States) is included with purchase.
• LIVE Experiences will be booked at a mutually agreed upon date and time between the Connecticut Science Center presenter and the purchaser.
• Programs must be booked at least 2 weeks in advance of the requested date to allow for shipping.
• Listed activities are subject to change without notice due to material supply shortages or other unforeseen circumstances. Canceled activities will be replaced with something of equal or greater value.
Enrichment Kit Programming

Enrichment Kit


Live Experience Pricing: $250 per program — all materials included
Capacity: Up to 25 students per program
Length: 60 minutes

Pre-recorded Session Pricing: $175 per recording — all materials included
Capacity: Up to 25 students per program
Length: varies by program

This is the original Science at Home Kit experience for larger groups and includes either a LIVE session with one of our STEM Educators or a pre-recorded session allowing you to complete the activities at your own pace. Both options include all the materials needed to conduct the experiments.
Would you like a Live or Pre-recorded program?
Program Options
Would you like to add supplies for an extra 10 participants for $90?

Enrichment Kit PLUS


Live Experience Pricing: $350 per program — all materials included
Capacity: Up to 25 students per program
Length: 60 minutes

Pre-recorded Session Pricing: $250 per recording — all materials included
Capacity: Up to 25 students per program
Length: varies by program

We took the original Science at Home Kit experience for larger groups, and we enhanced it with bigger and bolder experiments and upgraded supplies to complete those experiments. This version, like the original, includes either a LIVE session with one of our STEM Educators or a pre-recorded session allowing you to complete the activities at your own pace. Both options include enhanced materials needed to conduct the experiments.
Would you like a Live or Pre-recorded program?
Programs Options
Would you like to add supplies for an extra 10 participants for $90?

Enrichment Kit Bundle


Pricing: $500 per bundle — all materials included
Capacity: Up to 25 students per program
Length: 60 minutes for Live Experience, time varies for Pre-recorded Sessions

Get the best of everything! We will include one (1) live experience (from the Plus collection) and two (2) pre-recorded sessions (from the original collection).
Please select a Live Experience Plus program:
Please select 2 Pre-Recorded programs:
Would you like to add supplies for an extra 10 participants for $90?

Girl Scout Programming


Pricing: $200 per class
Capacity: Up to 25 scouts per class
Length: 45 minutes
Availability: Monday-Friday, 9am-6pm. Must be booked at least 2 weeks in advance

Program Requirements:
• Computer to stream the live program
• WiFi connection
• Speakers & microphone capabilities (can be through a laptop, desktop, or webcam)
• Screen to share the computer with a larger audience (optional)
Girl Scout Programming

Virtual Program Logistics


2022 STEM Career Showcase Dates:
• Friday, March 25, 2022
• Tuesday, May 3, 2022
• Friday, June 3, 2022
• Friday, November 4, 2022
• Tuesday, December 6, 2022

How many classes would you like to book?
How would you like to schedule your classes?

Science at Home Kit Shipping Info

Please fill out the mailing information below
Mailing Address
Mailing Address
City
State/Province
Zip/Postal

Payment Information

Full payment is required prior to your program. If you are unable to make payment in advance, please contact the Reservation Center to make alternate payment arrangements.

Virtual Programs: reservations@CTScienceCenter.org or 860-520-2150
Traveling Programs: outreach@CTScienceCenter.org or 860-520-2165
Is your program being funded by a grant?