Mars Field Test Registration Form
If you are interested in being involved in the Mars Field Test Program, please complete the form below as completely as possible and send it to us by clicking the "Submit this form now!" button at the bottom of this page. Participation may be limited, and we will contact you concerning your school's participation.

Contact Name:



Dr.
Mr.
Ms.
Miss

First Name


Last Name

Title/Position:
School/Institution:
I prefer to be contacted at:School Home Other
Mailing Address:(street)
(city) (state) (zip)
Phone Number:()- Ext.#
Area Code   Phone #
Fax number:()-
Area Code   Phone #
E-mail address, if you have one:



Number of students attending your school:
Grade levels at your school:
Locality:
School Type:
Please list any innovative science or math programs in which you or your colleagues have been involved, if any.



Number of minutes per week your students study science:
What science topics do your students study during the year?

What have you already done regarding Mars, solar system or space studies?


What technologies are readily available to your class? (check as many as apply)
Computers    CD-ROMs    E-mail    WWW/Internet Access



Preferred start date: (Enter as estimated month/date/year)
Grade level(s) to be involved in the field test:
Number of teachers to be involved:
Number of students to be involved:
In-depth units in which you are interested:


These units will be: used as the full curriculum for a certain period of time
used in conjunction with existing earth and space science curricula

or


For more information, send e-mail to: marsed-info@teaparty.terc.edu or visit our Web page or call Chris Randall (617) 547-0430