Complete and return this form by October 22, 2001 either through this website or by mail to Stephanie Stathopoulos, Department of Chemistry, University of Minnesota, 207 Pleasant Street S. E., Minneapolis, Minnesota 55455 or fax to (612)626-7541. Only one demo per form.

 


Contact Person

Representing

Address

Phone Number(s)

Fax Number

email address


Names of all students doing demo:

Name of Teacher and Phone Number:

Title of the demonstration:

Brief description of the demonstration:

Chemicals, special equipment, and space needed to set up and operate the demonstration. List only those items you would like us to provide:

Comments:

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