Virtual Incursion Enquiry

Please note: all fields are required in order to submit.

Primary Contact Person

Name

Mobile Number

Email

Group details

Name

Phone Number

Street Address

Suburb/Town

State

Postcode

Type of group
—Please choose an option—Preschool & Child CarePrimary SchoolVacation CareDisability ServiceHome School

Age of group
—Please choose an option—Preschool (Ages 0-5)Early Stage 1 (Kindergarten)Stage 1 (Years 1 and 2)Stage 2 (Years 3 and 4)Stage 3 (Years 5 and 6)Stage 4 (Years 7 and 8)

Maximum number of children/student attendees

Maximum number of adult attendees (including teachers and parent helpers)

Booking details

Preferred date #1 dd-mm-yyyy (unconfirmed until notified by Science Space staff)

Preferred date #2 dd-mm-yyyy (unconfirmed until notified by Science Space staff)

Preferred date #3 dd-mm-yyyy (unconfirmed until notified by Science Space staff)

Preferred start time (check all suitable times)
9:00am9:30am10am10:30am11am11:30am12pm12:30pm1pm1:30pm2pm2:30pm

What Virtual Experience would you prefer?
—Please choose an option—Liquid Nitrogen Science Show: 30 minsBubbleology Science Show: 30 minsSolar System Expedition Planetarium Show: 30 minsDestruction STEM Challenge: 40minsShipyard STEM Challenge: 40minsBridge Builder STEM Challenge: 40mins

How did you find out about us?
—Please choose an option—Email newsletter for teachersFlyer or brochure received at schoolGeneral internet searchSocial mediaScience Space websiteWord of mouthPrevious visitOther

Are you interested in receiving our email newsletter?
YesNo

By submitting this booking request I understand and agree to the following:

This is an online request only. Your booking is NOT finalised until the Science Space has processed your request and provided a confirmation of booking date and indicative cost.

If you have any questions, please contact the Science Space booking office (Monday to Friday). Phone: (02) 4286 5000 Email: science-space@uow.edu.au

Your personal details are collected for the sole purpose of providing you with advice regarding a Science Space excursion, and if indicated, adding you on our enewsletter distribution. For more information please see the UOW Privacy Policy.

N.B. Please use the following format for preferred excursion dates: dd-mm-yyyy