EmailMe Form - Students In Action

Student Service Program Price Scale:

$200 Base cost (up to 20 students)
$10/Student for additional students (up to 50 students)

For example, a group of 25 will cost $250 ($200 base plus $50 for 5 additional students)

*We frequently have grant funding for partial scholarships for qualifying schools. If interested, please fill out the appropriate section below. *

I understand the pricing scale, and that payment is due 3 days prior to scheduled program.

GROUP INFORMATION

School/Group Name *

Physical Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

School/Group Type *

Mailing Address (If different from Physical Address)

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Student Group Age or Grade *

Service Activity Interest Areas

Habitat Restoration

planting marsh grass

Oyster Reef building

Water Quality testing

Aquatic Species Identification

macro trash cleanup

micro trash/nurdle cleanup

prairie restoration

Other (Please Describe)

Choose all fields that interest or apply to your student group. GBF Educators will consult GBF Habitat Restoration Managers to determine possible service activities.

Learning Activity Interests *

Seining/organism ID

oyster reef monitoring

bird adaptations and viewing

nature hike

plankton tow/id

marine debris discussion

testing water quality

calculating biodiversity/food webs

Other (Please Describe)

Choose all fields that interest or apply to your student group.

*All groups will participate in a reflection at the end of the day and leave with a memento to take home with them.

Please select the corresponding level of science you would like your students to receive during the event so we can customize your experience: *

Low (my students need the basics)

Average (my students have knowledge of aquatic science/environmental topics, but may not remember much)

High (my students have received and understand AP or upper level science knowledge and may be looking into pursuing a careers in a science field)

Number of Student Participants *

Number of Chaperones *

Minimum 1 chaperone for every 12 students (number of chaperones may vary based on activity, age, and number of students)

Lead Contact Name *

First Last

Lead Contact Email *

Lead Contact Phone *

### - ### - ####

Best way to contact you?

email

phone

SCHEDULING INFORMATION

Preferred Date *

MM / DD / YYYY

GBF will not schedule groups Saturday, Sunday, or Monday. GBF will not schedule groups on Holidays.

Date- Choice 2

MM / DD / YYYY

GBF will not schedule groups Saturday, Sunday, or Monday. GBF will not schedule groups on Holidays.

Date- Choice 3

MM / DD / YYYY

GBF will not schedule groups Saturday, Sunday, or Monday. GBF will not schedule groups on Holidays.

Additional Information

Any special concerns or requests, such as students with disabilities, strict schedules, etc.

How did you hear about this program? *

SCHOLARSHIP INFORMATION

The goal of GBF education scholarships are to enable schools with limited resources the opportunity to experience a variety of hands-on environmental education programs that are designed to enhance scientific equipment skills, knowledge of the local ecosystem, teamwork, critical thinking skills, and promote advocacy for Galveston Bay. If you would like to be considered for a full or partial scholarship, please fill out the following section.

Scholarship Requirements - schools receiving a scholarship will be responsible for the following:
• Appropriate Communication with GBF staff.
• Post-Program evaluations filled out completely.
• All pre-test and post-tests completed (depending on program).

*Scholarships do not include bus transportation.

Please check the scholarship amount you would like to request:

Full scholarship

Partial scholarship

If full scholarships are not available, will you be able to participate in the program with a partial scholarship?

yes

no

Percentage of students currently attending school that qualify for free/reduced lunch program:

Please describe why your school is a candidate for an education scholarship and what financial barriers challenge your school:

How will this program positively impact your students?