Educational Program Request Form
To order, please call 815-235-4125, fax 815-232-9006, or mail copy of request form to:
Stephenson Extension, Highland Community College, Bldg. R,
2998 W. Pearl City Rd., Freeport, IL 61032
SCHOOL____________________PHONE________________GRADE_____________
CONTACT TEACHER____________ PARTICIPATING TEACHERS______________
NUMBER OF STUDENTS______DELIVERY DATE_______PICKUP DATE_______
ALTERNATE DATE ACCEPTABLE: _____ YES _____NO
EXTENSION STAFF PRESENTATION _____YES _____NO
Your request will be confirmed before delivery. A pick-up date will be attached to the materials. PLEASE HAVE ALL MATERIALS IN THE SCHOOL OFFICE ON THE MORNING OF THAT DAY. THANK YOU!
Bev Haselhorst, Educational Programs Coordinator, Stephenson County Extension
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Please circle unit requested. Make a copy of this page and use a separate request form for each unit.
Environmental
Cooperative Conservation
K-2
3-4
5-6
Disappearing Earth
Earth Day is Every Day (spring notification)
Environmental Aware. Series
Gee Whiz in Agriculture
Help Save Planet Earth
Plants, Soils, and Gardening
Recyclable/Renewable Resources Kit
Fine Arts
Performing Arts
Prairie Places and Art
Discover the Arts - Visual Arts
Life Skills
Bicycle Kit
Character Counts
PreK-K
1-2
3-4
5-6
Character Critters
Classroom Pyramid: Team Building
Cool Cash Adventure Kit
Culture Kit – country: ____________________
Farm Safety for Kids Kit
Let's Talk About Money Kit
Ohio Cloverbud Material
Operation Safe Kids
Polite is Right
Public Adventures
Raising Credit Smart Kids
Talking With T.J.:
Teamwork
Conflict Resolution
Walk in My Shoes
Welcome to the Real World
Wild Over Work
Nutrition
Classroom presentations:
Dairy Difference
Food Guide Pyramid
Taste of the World – culture: __________________
Clean Hands Kit
Sports Nutrition
Recreation
Recreation Kit
Science
Blue Sky Below My Feet
Cat, Dog, and Rabbit Kit
Computer Mysteries Kit
Electricity Kit
Embryology
Entomology Kit
Geology Kit
Gifts of Gold
Magic School Bus:
Season 1
Season 2
Season 3
On the Farm Kit
Operation Overboard Kit
Wonderwise Science – scientist: __________________