Michigan Astronomy

Submit Request to Astronomy Outreach Program

** Mandatory fields are highlighted and preceded by an asterisk

*Organization or Event name:

Contact Information
*Full Name:
Address:

*Please provide a way to contact you (one or both of these is required):

*Phone

*E-mail Address:

Event Information

Region:
Age Range:
Preferred Event Date:
Backup Event Date:
Approximate Number of Participants:
Specific Request:

*Description
Include any special comments or information (e.g. if the event must take place on a specific day explain why)




Click the SUBMIT button to send your request.

You will receive an e-mail or phone call from a contact person within a few days. Please contact the astronomy department at 734-764-3440 if you do not get a response or astroweb "at" umich.edu if you experience problems using this form.