Name of Institution and/or Group* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Contact Name* Contact Phone Number - Cell Number*Contact Phone Number - School Number*Email Address* Total Number of Students* Total Number of Chaperones* Age Range or Grade Level(s) of Group* Names and Emails of Fellow Teachers Attending This Field tripDate Requested - 1st Choice* MM slash DD slash YYYY Date Requested - 2nd Choice* MM slash DD slash YYYY Time of Visit Requested - 1st Choice* : Hours Minutes AM PM AM/PM Time of Visit Requested - 2nd Choice* : Hours Minutes AM PM AM/PM Length of Visit* Briefly describe purpose for visiting the IQhub* Which STEM aligned program are you interested in? How Do Plants Grow? (Pre-Kindergarten) Apples and Bees (Kindergarten or 1st Grade) Farm to Fork (Kindergarten or 1st Grade) Pollinators for Healthy Foods (2nd or 3rd Grade) The Three Sisters (2nd or 3rd Grade) Vermicomposting (2nd or 3rd Grade) Field to Fitness (4th or 5th Grade) Plant Picasso (4th or 5th Grade) Vermicomposting (4th or 5th Grade) Water Cycle (4th or 5th Grade) Birds and Bees of Plants (6th - 8th Grade) Careers in Agriculture - MS (6th - 8th Grade) Forestry (6th - 8th Grade) Plant Picasso (6th - 8th Grade) WWW - Wonderful World of Water (6th - 8th Grade) Careers in Agriculture - HS (9th - 12th Grade) Cool Chemistry (9th - 12th Grade) How Important is the Soil? (9th - 12th Grade) Introduction to Genetics (9th - 12th Grade) Protein Please (9th - 12th Grade) Real Science - Why is being "Green" and the Scientific Method so important? (College) AgroLiquid - Commitment to Environmentally Friendly Products (College) Please help me build a "Custom Program" (This is used to combine programs) Which activities are you interested in? (These choices go with the program selected above.) "Apples and Bees" Choice #1 - Apple Tasting (Kindergarten or 1st Grade) "Apples and Bees" Choice #2 - Apple Cider & Juice Tasting (Kindergarten or 1st Grade) "Farm to Fork" Choice #1 - Butter Making (Kindergarten or 1st Grade) "Farm to Fork" Choice #2 - Cheese Tasting (Kindergarten or 1st Grade) "Pollinators for Healthy Foods" Choice #1 - Apple Cider Demo & Tasting (2nd or 3rd Grade) "Pollinators for Healthy Foods" Choice #2 - Fruit & Veggie Bingo (2nd or 3rd Grade) "Pollinators for Healthy Foods" Choice #3 - Honey Bee Hustle (2nd or 3rd Grade) North Central Research Farm Tour (3rd Grade - College) Motz Park Aquatic Biological Assessment (4th Grade - College) St Johns Woodlot Forestry Experience (6th Grade - College) LEED Building Tour (9th Grade - College) St Johns City Park (All Grades) Andy T's Farm Market (Appointment Only: 989-224-7674) Humble Beginnings Ranch (Appointment Only: 989-627-2462) Phillips Orchard & Cider Mill (Appointment Only: 989-292-5252) Uncle Johns Cider Mill (Appointment Only: 989-224-3686) In terms of programming, can the IQhub create a lesson or add a topic area that would be relevant to what your students are currently learning?* Will you be eating lunch at the IQhub? Yes, we will bring sack lunches Yes, we will arrange for lunch to be delivered No, our trip is not during lunchtime CommentsThis field is for validation purposes and should be left unchanged. Stay In Touch with the IQhub Email* CommentsThis field is for validation purposes and should be left unchanged.
