Early Bird Field Trip Registration Host an IGNITE Field Trip: Fall 2023 Thank you for supporting IGNITE Events! Please complete this form to sign up to host an IGNITE Field Trip in fall 2023. If you have any questions, please contact your IGNITE Program Team representative or email contactus@ignite-worldwide.org Order Number Company Name * How would you like your company's name displayed to teachers and students? * Primary Contact Name * Primary Contact Email * By adding your email above, you are consenting to receive emails from IGNITE Worldwide. Primary Contact Phone * Secondary Contact Name Secondary Contact Email By adding your email above, you are consenting to receive emails from IGNITE Worldwide. Secondary Contact Phone NOTE: We are a small team and primarily use email to share important event information and updates. We may occasionally contact you by phone to ensure timely receipt of information. In what region will you host your Field Trip? * Puget Sound Area (Washington) San Francisco Bay Area (California) Where are you located? * Please submit a 3-hour time block * How many students can you host at your event? * Get students excited about your event! Please provide a 2-3 sentence student-friendly description of your company. * Please provide a 2-4 sentence description of your Field Trip (ie. What activity will students engage in? What topic(s) will they learn about?) * Is your company able to provide swag to students who attend your event? * Yes - Please describe swag below No Please describe what swag item(s) you will offer. Would your event be tailored to a specific age group? * Open to both middle and high school High school only Middle school only Not sure yet Would you be open to college/postsecondary education IGNITE Students attending your event? * Yes No Would you be open to 4th and 5th grade IGNITE Students attending your event? * Yes No Please provide the Field Trip building address, bus arrival and drop-off instructions, and where buses should park. * Does your company require a list of attending student and chaperone names? * Yes No - Just a headcount Are there any COVID protocols in place at your company that teachers should be aware of? * Please list any other visitor requirements