Alcoa Cleveland Metropolitan School District Initiative Order Form

SPECIAL INITIATIVE
* Please select your Special Initiative: Alcoa Cleveland Metropolitan School District Special Initiative
SCHOOL/TEACHER INFORMATION
* School District Cleveland Metropolitan School District * School Name NOTE: Please use the full school name (Example: Forest Wheeler Elementary School NOT Wheeler) School Address (Will NOT ship to P.O. Box) * Street * City * State OH * Zip * Teacher Name * Teacher Email Best Contact Number (For Volunteer to Reach you) * Did you attend an AWIM workshop? No Yes Where: When: * Has your principal/administrator approved the use of AWIM? (SAE will only send kits to teachers with administrative approval) Yes No * Principal's Email: (Your principal will be carbon copied on your order confirmation email.)
CLASSROOM MATERIALS
SAE International will provide a classroom materials kit to K-12 teachers only. Please select the kit your special initiative supports. Each kit contains enough materials for 27-36 students (in design teams) Elementary Gravity Cruiser Materials Kit JetToy Materials Kit If you have ordered JetToy materials in the past, please select one of the following: JetToy Partial Materials Kit (contains all materials except pumps - Please order a partial kit if you participated last year.) Specific Order Requests:
PARTNER INFORMATION
Note: A partner is a representative from your special initiative. The role of the partner is to contribute to the students' understanding of the engineering design, scientific, or technology experience. * Partner Name: Carl Garesche * Partner Employer Name: Alcoa Partner Occupation: Engineer Partner Employer Address * Street: 6450 Rockside Woods Blvd. * City: Independence * State: Ohio * Zip: 44131
* I agree to credit SAE International as the originator of the A World In Motion® curriculum in any publicity, interviews, or articles resulting in the use of the program.