The Science Survey

    Name:

    Age:

    Email:

    Phone Number:

    What do you want to be when you grow up?

    What is your favorite kind of science:

    If Other

    What is your first memory of science?

    Who was the first person who showed you science?

    Have you lost interest in Science as you get older:
    YesNo

    Why or what not?

    Is science at school boring?:
    YesNoSometimes

    What do you think would make science more fun?

    Do you think doing science projects with your parents or family outside of school would make your more interested in science?
    YesNoSometimes

    What kind of science would you like to be with your parents?


    If you were at one of Lindsay's events:

    Was today’s Science fun?:
    YesNoSometimes

    What part did you like best?

    What could I do to make it more fun?

    Parents: My goal is to collect data on what kids want to do when they grow up, why they want to do it, and where and why they are losing interest in science and what we can do to keep them in science. I will not contact your minor age child without your permission and I will only do it via phone or email. I am available to provide mentoring, resources, personalized science events, or simply listen to stories about science and what it has done in your life. Thank you.

    Please sign here granting me permission to follow up via phone or email

    Parent or Guardian Signature:

    Please feel free to write any additional comments or questions below:

    [recaptcha]