Power Town Presentation Interest Form

Power Town Display

Power Town is a table top display using small scale model of power lines, a house, trees and electrical equipment to teach students how to be safe around electricity.

Presentation slots require 30-45 minutes each (approximate)
- 30 minutes excludes video
- 45 minutes includes video
Offered M-F Morning & Afternoon availability
Inside and/or covered area required for presentation
Video option (45-min presentation) requires AV capabilities on site
Power outlet must be accessible
Presentations is designed for Pre-K - 5th grades
Public, Private, Homeschool Groups, Boy/Girl Scouts, Summer Programs, etc.

Which presentations are you interested in?

Contact Name

First NameLast Name

Phone Number

Format: (000) 000-0000.

Phone Extension

Optional

Cell Phone

Please enter a valid phone number.Format: (000) 000-0000.

Your E-mail Address

example@example.com

What is the name of your campus?

What is the best method of contact for you?

Campus Address

Street Address

Street Address Line 2

CityState

Zip Code

Because of the 24 school districts in our service territory, we limit presentations to a lower grade (suggested Kinder or 1st) and 5th grade classes. The lower grade levels are introduced to electric safety while 5th grade presentations review electric safety, energy conservation and energy resources. The representative that contacts you can answer any questions concerning this. Our goal is to come back annually for those same grade levels.

Rows	Pre-K	K	1st	2nd	3rd	4th	5th
Estimated # in Attendance by Grade Level

Select up to 3 days that work best for a scheduled Power Town presentation?

Select the time frame that works best for your group. Presentations can begin as early as 9 a.m. We will arrive 30 minutes early to set-up.

How did you hear about the Power Town presentation?

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