Public Outreach Event Reporting
*required fields

 

Event Info:

Presenter's Name: *

Presenter's Email:

Presenter's Affiliation: *

Start Date: *

End Date: *

Name of Event: *

Event Sponsor:

Host Institution: *

Location of Event:

Street:

City: *

State: *

Zip: *

 

Audience info:

Total Attendance: *

Attendance Breakdown (if known):

Teachers: Grades Taught:

Students: Grade Level(s):

Family/General Public:

 

NASA/OSS Materials Distributed:

Total number of NASA educational materials distributed:

Number of NASA individual educational materials demonstrated by presenter/s during the program:

Short Description:*

Additional Information (include speakers/resources/comments):