Virtual Physics -- the 10 cent tour

Online Physics for Teachers

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Hands-On Courses for Elementary and Middle School Teachers

Registration for Professional Development

Instructions

1. Please complete this form and print it.

2. Click on "Submit" to send us an electronic copy.

3. Mail the printed form with your check or purchase order to the address below.


	First Name:
	Last Name:
	Your email address:
	Names of up to 2 others in your group (optional):
	Grade(s) you teach:
	School Name:
	School Address:
	District:
	City:
	State and Zip:
	Country:
	Phone number where we could call (optional):

	To which address to send course materials? school home

	If you checked home, please give us your home address:
	Street Address:
	City:
	State and Zip:
	Country:

	Make your course selection(s) by checking the appropriate box(es). Each course earns 30 hours of Professional development credit (subject to your school's approval):
	Light
	Electricity and Magnetism
	Temperature and Heat
	Force, Motion, and Energy

	What approximate date would you like to start the course(s)?

	What approximate date do you plan to complete the course(s)?
	(between 2 weeks and 3 months after the start)

	Please use this box to send any comments or questions:


	Payment
	Pricing:
	For U.S. shipping addresses: $200 per course (regardless of whether it is for 1, 2, or 3 people). The $200 fee covers instruction and 1 materials kit.
	Shipments outside of continental U.S. will require additional charge to cover shipping.

	Check or Money Order (Total)
	(Please make payable to University of Kentucky.)
	Purchase Order Number (include printed P.O. with mailing)
	Print this form before submitting. Mail the printed form with your check, purchase order, or money order to: Science Works Program Department of Physics & Astronomy Room 177 Chemistry-Physics University of Kentucky Lexington, KY 40506-0055
	Click here to your registration or If this form doesn't work, let us know at sciworks@pa.uky.edu