Montana Frontier States Initiative Order Form

SPECIAL INITIATIVE
* Please select your Special Initiative: Montana "Frontier States" Initiative
SCHOOL/TEACHER INFORMATION
* 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 * Zip * Teacher Name * Teacher Email * Did you attend an AWIM workshop? No Yes Where: When: In which grades do you plan to use A World in Motion®? (select all that apply) 1 2 3 4 5 6 7 8 9 10 11 12 * 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. Elementary Skimmer Materials Kit Gravity Cruiser Materials Kit JetToy Materials Kit If you have ordered Skimmer or JetToy materials in the past, please select one of the following: Skimmer Partial Materials Kit (contains all materials except fans) JetToy Partial Materials Kit (contains all materials except pumps) Middle School Motorized Toy Car Materials Kit Glider Materials Kit Fuel Cell Challenge 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: Partner Telephone: Partner Email: Partner Employer Name: Partner Occupation: Engineer Scientist Professor College Student Retired Other Partner Employer Address Street: City: State: Zip: Is the partner an SAE member? Unknown No Yes Section name:
* 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.