Document 15621991

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Lake Champlain Live Lab or Keeping the Balance Lab Program Application

A UVM Extension/Lake Champlain Sea Grant program in partnership with the

Rubenstein School of Environment and Natural Resources www.uvm.edu/watershed

PLEASE INDICATE (CHECK) WHICH PROGRAM(S) YOU WOULD LIKE TO REGISTER FOR:

Lake Champlain Floating Laboratory (2 hours; Middle and High School; 22 participant maximum including adults)

Keeping the Balance (1 ½ - 2 hours; Middle and High School)

Part I. Contact Information and Background

Teacher Information:

Home Phone: Name:

School Name and Address:

Work Phone: Email:

What are the best days/times to contact you by phone and at what number?

Teaching Assignment:

Please list the course(s) you plan to include in the Keeping the Balance and/or Lake Champlain Live

Program.

Science courses Grade(s) # Students

Lake Champlain Live is offered May - November (weather permitting) and Keeping the Balance, April

- November. Please give your first and second choices for program dates and times. Programs are scheduled on a first come, first served basis.

PLEASE RETURN APPLICATION BY MAIL OR EMAIL TO:

Erin De Vries

Outreach and Education Coordinator

UVM Watershed Alliance

Rubenstein Ecosystem Science Laboratory

3 College Street

Burlington, VT 05401

Phone: 802.859-3086 x305 erin.devries@uvm.edu

● www.uvm.edu/watershed

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