Science Ambassadors

UTA Campus Visit

Cost: $125 for first 50 plus $1.50 per additional person (through August 31, 2026)

NOTE PRICE INCREASE: Beginning September 1, 2026, the cost per show will be $150 for the first 50 plus $2.00 each additional person. (Lock in your price for the 2026-27 school year before 9/1/26)

**Please note: This request form is not a show confirmation. You will be contacted soon to confirm availability.

SCHOOL/GROUP
School/Group Name
School District/ Campus Location
State or Federally Funded?

Is the school state or federally funded?
Number of Teachers
Number of Chaperones
Number of Students

Number attending including students and parents/chaperones.
Grade Level(s)
CONTACT
Contact Name Contact Name First Last
Email
Phone Phone - ### - ### ####
SCHEDULING
Date Date / MM / DD YYYY
Time Time : HH MM AM/PM
Alt. Date Alt. Date / MM / DD YYYY
Time Time : HH MM AM/PM
ADDITIONAL
Do you plan to pay by credit card?

Do you plan to pay by credit card? No Yes
Comments

If splitting into smaller groups, please include a breakdown of what time you want for each show and how many will be in each group.

Science Ambassadors

SCHOOL/GROUP

CONTACT

SCHEDULING

ADDITIONAL