TOPS Lending Kit Program - Reservation Form

Please use this form to make all requests for TOPS Lending Kits for the 2011 - 2012 academic year.

Several TOPS Lending Kits have more than one lab activity (e.g. Thermodynamics Kit - 4 lab activities). If you choose to request multiple activities from a given kit please request each activity on a separate line. For example, if you wish to do the Absolute Zero and Gas Laws actvities from the Thermodynamics Kit, request Absolute Zero on one line and Gas Laws on the next. Both activities should have the same set of dates. Regardless if you select one activity or all four activities from the Thermodynamics Kit it will count as one kit request of the five you may have per year provided that the activities selected are all done during the same week. Please see the TOPS 2011 - 2012 Lending Kit Program Memorandum of Understanding for more information.

TOPS Lending Kits will be available from 15 August 2011 to 15 June 2012. Kits are only available to teachers who have participated in Phase I and Phase II of the TOPS Programs and have submitted a signed 2011 - 12 MOU and Lending Kit Guidelines form to the TOPS Office.

Name:		School:
E-mail:		Number of classes:
Biology	Chemistry	Physics

Lab name:	First Choice Week	Second Choice Week	Third Choice Week

* = The Thermodynamics lab may only be requested by chemistry and physics teachers who have completed the supplemental training session for this lab. The next training is scheduled for summer 2011 during the TOPS chemistry workshop.

+ = The Biotechnology lab is scheduled for beta tests during the 2010 - 2011 school year. A supplmental training session for this lab is scheduled for fall 2011.

Please enter any special requests or concerns below. If possible, let us know holiday dates (Columbus Day, Thanksgiving, Winter/Spring Break, Semester Break, etc.) Also, if there are pupil-free dates that will affect delivery or pick-up times, please let us know about those as well.

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Last Updated: July 20, 2011