Artemis ROADS II Professional Development Supply Request

Name *

First

Last

Organizational (e.g., school) Email *

Confirm Email

Please provide an email address you will have access to at all times, including during school breaks.

Backup Email *

Confirm Email

Please provide a back-up personal email address you will have access to at all times, including during school breaks. This is useful in case your organization's security blocks our communications.

Phone *

Are you requesting professional development supplies? *

Note: International educators (non-US states or territories) are welcome to join but are not eligible to receive stipends or supplies

Do you plan to attend Live Session 2 on October 3rd, 2023 4:30 to 6:30 PM PST?

Yes
No
Not sure yet

Supply Request Information

School Demographic Information

Please tell us about the demographics of students at your school or organization. We are funded by a federal grant that requires us to report this information.

If you aren't sure, you can look up information for your school on the the National Center for Education Statistics:

NCES Information for Public Schools

NCES Information for Private Schools

We understand that some educators work at unlisted schools, homeschool, or other organization. In that case, please select the appropriate values and estimate demographics of your students when possible.

Name of School or Organization *

Is your school Title 1 eligible? *

Yes
No
Not sure
Does not apply because I am not a teacher at a listed public or private school.
Does not apply because I am a homeschool educator.
Does not apply because I am an educator at another type of organization.

What percent of your students are eligible for free or reduced lunch? *

Less than 25%
25 to 50%
50 to 75%
75 to 100%
Not sure
Does not apply because I am not a teacher at a listed public or private school.
Does not apply because I am a homeschool educator.
Does not apply because I am an educator at another type of organization.

What percent of your students at your school or organization identify as one of the following race or ethnicities American Indian/Alaska Native, Native Hawaiian / Pacific Islander, Hispanic, or Black? *

Less than 25%
25 to 50%
50 to 75%
75 to 100%
Not sure
Not comfortable estimating

What is the average number of students engaged in your classroom or through your organization? *

Professional Development Supply Loan Agreement

NESSP is funded through a federal grant from NASA's Science Activation Program. The materials provided for the Artemis ROADS II Professional Development Workshop are loans that must be used by the educators in the workshop or with K-12 students participating in NESSP activities, including the National ROADS Challenge, the ROADS Companion Course, or the summer Mini-Missions.

Educators who complete the Professional Development but choose not to or cannot engage students in one of these programs must return the non-consumable supplies loaned to them. This ensures that these supplies can be provided to an educator participating in NESSP programs.

To facilitate the return process, NESSP provides a return label with all shipped items. In case this label is misplaced, educators can request another label at: https://nwessp.org/supply-return/.

Furthermore, educators who have previously received and are still in possession of loaned materials should refrain from requesting additional duplicate materials (e.g., an extra robot). NESSP can provide additional materials for your classroom through its Companion Course Classroom loans at a later date.

We sincerely appreciate your participation in NESSP programs and your cooperation in helping us support and inspire as many students and educators as possible.

Please sign to confirm that you agree to the terms of the Professional Supply Loan Agreement above. *

What materials would you like to request? *

LEGO Spike Prime Robot
3D Pen
Water Bottle Rocket Launcher
Bicycle Pump (We have a limited supply please only request if you don't have one at home.)
Estes Altitude Tracker

Shipping Information

All NESSP shipments require a signature upon receipt.
We cannot ship to (most) PO Boxes.
FedEx will send an email with shipping information before delivery.
NESSP will do its best but cannot guarantee supply requests made within 2 weeks of the workshop or date of activity.

Supply Shipping Address Line 1 *

Supply Shipping Address Line 2

City/Town *

States *

Zip Code *

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Artemis ROADS II Professional Development Supply Request

Supply Request Information

Professional Development Supply Loan Agreement

Shipping Information

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