UMaine EPSCoR STEM Field Trips

UMaine Cooperative Extension 4H logos

Maine EPSCoR and University of Maine Cooperative Extension 4-H have teamed up to offer travel reimbursement (example: bus, mileage and/or driver) to Washington County schools/youth programming for field trips! Please complete the form below by December 19, 2018 to receive reimbursement.

You will need the following information to complete the form:

Field trip details
Participant information including gender, ethnicity and grade totals
1-2 participant quotes about their field trip experience
3-5 photos of field trip including University of Maine Photo Release for those featured in the photos
Invoice/purchase order for field trip costs addressed to: Robert Macleod, EPSCoR Office, University of Maine, 5616 Corbett Hall, Orono, ME 04469

For questions, please contact Jen Lobley by telephone at 207.255.3345 or by email at jennifer.lobley@maine.edu.

UMaine EPSCoR STEM Field Trips Form

Please complete this form to receive reimbursement for travel associated with a STEM-related field trip. This form must be submitted along with photos, photo release forms and PO/invoice by Wednesday, December 19, 2018 to receive reimbursement.
School or Program Name
Name of Contact Person
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Field Trip Destination
Number of Miles Roundtrip to Field Trip Destination
Please list the gender totals of all youth participants.
Male Female
Please list the ethnicity totals of all youth participants.
American Indian/Alaska Native Asian Black or African American Hispanic or Latino Native Hawaiian or other Pacific Islander White (Caucasian) Unknown
Please list the total number of youth participants for each grade.
K 1 2 3 4 5 6 7 8 9 10 11 12
Please provide a paragraph summarizing the impact of the trip on the youth and/or your program.
Please submit 1-2 quotes from youth, include first name and age.
Example- Jane, 10 "I had fun. I learned about whales. I want to be a marine biologist." Jack, 12 "This was a great experience. I held a starfish."
Please upload three to five photos from the field trip.
Drop files here or

Max. file size: 1 MB, Max. files: 5.
Photo releases are needed for all individuals that can be clearly seen in the photos you submit. Completed photo release forms can be mailed or dropped off to 28 Center Street, Machias, ME 04654 or faxed to 207.255.6118.
Please upload a purchase order/invoice here.
Max. file size: 1 MB.
The purchase order/invoice should be addressed to: Robert Macleod, EPSCoR Office, University of Maine, 5616 Corbett Hall, Orono, ME 04469
Thank you.

American Indian/Alaska Native	Asian	Black or African American	Hispanic or Latino	Native Hawaiian or other Pacific Islander	White (Caucasian)	Unknown

Male	Female