We want to know what you think. Let us know what you think about our activities, how you used them, etc. We welcome comments from anyone using our activities. Some of the information below is used for statistical purposes. We use your comments and information to ensure continued funding.

First Name:                  Last Name:

State (where you live): Select your state Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Other / Not in the US

E-mail Address:

You are a: Teacher Student Parent Other

What activities did you use? (Hold control / apple key to select multiple activities)

                            The Carbon Dioxide Kit Balloon Blowup Dancing Spaghetti Acid/Base Column Stair Steps Liquid Carbon Dioxide The Polymer Kit Spot the Polymer Silly Putty Oobleck Rock the Diaper Other (Please list in comments)

How many people participated in the activity?

What is the current grade(s) of those who participated?

Kindergarten	First (1st)	Second (2nd)	Third (3rd)
Fourth (4th)	Fifth (5th)	Sixth (6th)	Seventh (7th)
Eigth (8th)	Ninth (9th)	Tenth (10th)	Eleventh (11th)
Twelvth (12th)	Special Ed.	Other / None

Comments (Suggestions, likes/dislikes, etc.):