MUN LTCancer

Educator name (first and last)*

Educator Email Address*

High school name*

High school address*

Phone Number*

Number of Students

Student 1

Student 2

Student 3

Student 4

Student 5

Student 6

Student 7

Student 8

Student 9

Student 10

Student 11

Student 12

Student 13

Student 14

Student 15

Student 16

Student 17

Student 18

Student 19

Student 20

Student 21

Student 22

Student 23

Student 24

Student 25

Grade of students: (please check all that apply)

Grade 10

Grade 11

Grade 12

Please indicate if any of the participating students have any health issues, allergies or dietary restrictions we should know about before the event.

Is there anything else we should know before the event?

Have you taken part in other Let’s Talk Science programs and events in the past?*

Yes

If yes, check all that apply:

Volunteer-led activities in my classroom

Community event hosted by Let’s Talk Science

CurioCity

IdeaPark

Tomatosphere

Let's Talk Science Challenge

Have you registered on the Let's Talk Science Portal (http://volunteer.letstalkscience.ca )? Through the outreach portal, we track activities that our volunteers complete and allow you to share your feedback with us. You’ll also gain instant access to online resources with CurioCity and IdeaPark. If you require assistance registering, please contact us.

If you would like to register to receive our periodic Let’s Talk Science educator e-newsletter, check the box below. The e-newsletter contains new information and opportunities about Let’s Talk Science programs and resources that might interest you. Let’s Talk Science is a charitable organization and e-newsletters are not used for commercial purposes.

I agree to receive periodic e-newsletters from Let’s Talk Science (check all languages below that apply)

English

French

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