Planning Tools: Event Planner

APS Member Coordinator Last Name*

APS Member Coordinator First Name*

APS Member Coordinator Email Address*

Institution*

Department*

Shipping Address Line 1*

Shipping Address Line 2

City*

State*

Zip Code*

Phone*

Date(s) of our visit to the classroom/school:*
Monday, November 2
Tuesday, November 3
Wednesday, November 4
Thursday, November 5
Friday, November 6
Other:

Other Physiologist/Scientist presenter(s) NAMES and POSITIONS/ACADEMIC LEVEL on team:

Other Physiologist/Scientist presenter(s) EMAILS on team:
Separate emails with semi-colons. These will be used for an online feedback survey.

Lead Teacher Coordinator LAST Name:*

Lead Teacher Coordinator FIRST Name:*

Lead Teacher Coordinator EMAIL address:*

SCHOOL NAME:*

School Street Address*

School City*

School State*

School Zip Code*

Other TEACHER NAME(S) on team hosting the Physiologist presenters:

Other TEACHER EMAIL ADDRESS(ES) on team hosting the Physiologist presenters:

Date(s) of PhUn Week Events:*
Monday, November 2
Tuesday, November 3
Wednesday, November 4
Thursday, November 5
Friday, November 6
Other:

Grade level(s) of STUDENTS participating in your PhUn Week Event:*
Check all that apply
Pre-K/Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Other:

TOTAL NUMBER of STUDENTS participating:*

TOTAL NUMBER of Physiologist/Scientist Presenters:*

TOTAL NUMBER of Teachers:*

TOTAL number of shirts requested by adult size:*
For Presenters/Teachers ONLY!

Small:*
Enter "0" if not requested.

Medium:*
Enter "0" if not requested.

Large:*
Enter "0" if not requested.

X-Large:*
Enter "0" if not requested.

XX-Large*
Enter "0" if not requested.

Our PhUn Week Lesson Plans will include...*
List activities per day, the Visit Day, and Homework (if assigned):

The structure of the Physiologist "Visit" and presentation...*
Indicate how the visit and presentation will be structured. Check off the activities that you are planning. It is NOT required to do all of the activities listed below. Together, decide the amount of time and the sequence of the activities (1st, 2nd, 3rd, etc.). Visit the Resources at www.PhUnWeek.org. NOTE: All lab or group activities and demonstrations must meet state K-12 safety standards and standards for use of animals in teaching.
Careers PowerPoint Presentation
Hands-on Workshop
Large Group Activity
Equipment Demonstration
Other:

Describe in further detail the allotted times and sequence of your PhUn Week Event:

Any additional comments, details, or questions?
You will not be able to return to this submission form. For any follow-ups, please directly email Mel Limson in the APS Education Office at: mlimson@the-aps.org.