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2. Teacher's First and Last Name*
4. Teacher's Email Address*
6. Teacher's Phone Number*
8. Name of School*
9. Grade Levels*
11. School Address*
13. Date of Event (if for a Guest Speaker, see below)
    Date of Event (if for a Guest Speaker, see below)
14. Number of Classes and/or Kits*
16. Program Options

    The Maricopa County Stormwater program has a menu of options to best suit the needs of your classroom. All resources are provided for FREE to educators within Maricopa County.

18. Please select all that apply*

    1. Stormwater Pollution Prevention Poster Contest Packet (for 3rd-6th grade only)
    2. K-2nd STORM & GO Maricopa County Stormwater Activity Packet
    3. 3rd-6th STORM & GO Maricopa County Stormwater Activity Packet
    4. 7th & 8th STORM & GO Maricopa County Stormwater Activity Packet
    5. Become a Stormwater Inspector - Guest Speaker Presentation K-8th Grade (35 students max per presentation) (Please provide dates below)
    6. STEM/Science event interactive display-- From Above: Use a model watershed (enviroscape) to learn about stormwater, stormwater runoff, and stormwater pollution --OR-- Below Our Feet: Use a camera to explore model stormwater pipes to find out what stormwater is, learn where the runoff goes, and discover common stormwater pollutants.
    7. Career Day
    8. Other (Please describe below)
20. Other Description
22. Become a Stormwater Inspector: Please provide three possible dates
24. Preferred Date
    Preferred Date
25. Alternative Date
    Alternative Date
26. Alternative Date 2
    Alternative Date 2
28. How did you hear about us?
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30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

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