Lending Library Registration Form

Name(Required)

First Last

Phone(Required)

Email(Required)

Position Title(Required)

Principal's name(Required)

School(Required)

District(Required)

Have you usedS4K before?(Required)

Yes

Is another teacher working with you to present this unit of study?(Required)

Yes

Other teacher's name(Required)

Grade(Required)

Number of students(Required)

Desired Unit(Required)

Adaptations

Ecosystems and Energy Flow

Electricity

Erosion

Gravitational Force

Introduction to Engineering

Makerspace

Magnets

Matter

Rocks/Minerals

Scientific Method

Waves

First Choice Date(Required)

MM slash DD slash YYYY

Second Choice Date(Required)

MM slash DD slash YYYY

Third Choice Date(Required)

MM slash DD slash YYYY

By clicking SUBMIT, you acknowledge the following:

1. I understand Science 4 Kern's units are designed for a maximum of two teachers.

2. I understand that units may only be kept on my school site for a maximum of 2 months.

3. I am responsible for all materials that need to be returned in the Science 4 Kern kit.

4. I have checked my calendar to ensure that the adequate time and days I have requested are adequate time to complete the unit's lessons.

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