Form

School District / Organization*

Job title*

First name*

Last name*

Email*

Phone number*

State (ie. AZ, CA, FL)*

Country*

How did you hear about us?

Other:

Check this box if you'd like to have a W9 Form & Sole Source Letter emailed to you.

Yes, please send me a W9 form & Sole Source Letter.

Product Interest:

BrickLAB

Enrichment Programs

Discover

Drones

Discover Drones Training

Virtual STEM Academy

Claymation

Cubelets Bot Builder

What grade levels do you oversee?*

Select all that apply.

TK-K

1-3

4-6

7-8

9-12

What role best describes your position?

District Administrator

School Administrator

Educator

Support Staff

STEM Coordinator

Family / Homeschooler

Implementing within:*

0-3 months

3-6 months

6-9 months

9-12 months

Which best describes your learning environment?

Before / After School

Classroom

Summer Program

CTE

Homeschool Co-Op

Tell us about your program and needs or the products you would like on your quote:*

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