Request Science Equipment from The Area Resource Center
21 Gilman Street
Waterville, ME 04901
(207) 872 - 6928

Name: E-Mail Address:
School: Street:
City, State, Zip: Phone #:

Item 1: Quantity
Item 2: Quantity
Item 3: Quantity
Item 4: Quantity
Item 5: Quantity
Preferred Delivery Date: Return Date:

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Briefly describe how the equipment will be utilized:

How many classes will use the equipment?

How many students will use the equipment?

Grade Level?

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