Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone

Email*

Enter Email Confirm Email

Which best describes who you are?*

I'm a student who wants to invent
I'm a teacher who wants to bring invention to my classroom or school
I'm a home schooler or youth group leader who wants to guide inventors outside a classroom
I'm an adult that would like to volunteer
I would like to offer financial support or resources for this program

What grade are you in?

What is your age?

What school do you attend?

How will you invent?

Do you have a teacher, parent, or mentor who is helping you?

What is the name and role of the person helping you?

(i.e. Lucille Van Pelt / teacher)

Would you be interested in sharing your invention journey with the Library and others?

Please provide phone or email so that we may contact your parent/guardian for approval to share your invention journey

What school do you teach in?

What do you teach?

In what setting do you work with potential inventors?

(i.e. home school, Girl Scouts, maker space)

How many inventors are you likely to be working with approximately?

Intent to Invent