Science, Engineering and Mathematics Link, In.
P.O. Box 93641 •Atlanta, GA 30377• Phone/ Fax: 678-496-5060
Email: info@semsuccess.org • Website: www.semsuccess.org

Math and Science Career Academy
School or Program Activity Request

20090726-2044

School Address

School Name:
Address:
City:
State:
Zip:
School Phone Number:

Best method of contact:

Phone Email

Teacher

Name:
Email Address:

For what type of fair are judges being requested?

Hands on Math
Hands on Science
Career Fair or Exploration
Other (Please specify)
Specify Other:

How many volunteers are you requesting?

1-3
4-6
7 or more

Please indicate the date(s) for the volunteers. Also, please indicate the specific times on these dates that volunteers will be needed

Dates please enter dates as>> mm/dd/yyyy	Times please enter times as>> hh:mm am

How did you hear about SEM Link’s Math and Science Career Academy?

Please submit at least four to six weeks prior to date needed