Today's Date
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School District Name and Number
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School Name
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School Street Address (including city, state, and zipcode)
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Current Principal Name
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Email Address (principal)
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Phone Number (principal)
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How many fifth grade teachers do you have?
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1 2 3 4 5 6 7 8 More than 8
5th Grade Classroom Teacher Names (list all)
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Teacher Email Addresses (list all)
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Teacher Phone Number (Please include extension)
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Primary Point of Contact - Please enter the name and contact information for primary person who will be coordinating details for the visit to STARBASE. (Please provide secondary contact information for being reached during summer months, if needed.)
School Hours for 2026-2027.
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If yes, please list below and explain the recurrence or frequency. Include the school hours for any early release days.
Please provide the name of your transportation company.
Transportation company contact name, phone, and email address.
Please list your major school breaks and days off other than major holidays.
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Please list any specific dates you are not able to attend STARBASE. Please note, this is not a section for preferences. Please only list dates for scheduled events, such as Wolf Ridge, conference nights, other annual field trips, holiday programs, music concerts, or other school/district events that may impact your availability to attend STARBASE.
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Student Information - Projections for 2026-2027
Please provide information for your school's 5th grade students.
Projected number of 5th grade classrooms for 2026-2027 school year
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1 2 3 4 5 6 7 8 9+
Approximate class size (per each of the classrooms above)
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Projected Total Number of 5th Graders for the 2026-2027 School Year. *If your anticipated classroom sizes are approaching 28 students or more, please be prepared to split your students into an additional classroom. If this happens, you will also need to provide an adult for that additional classroom.
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If you answered yes, please list the number of students in the additional grade level.
STEM Program Questions
Why do you feel the STARBASE program has been or will be an important part of your 5th grade curriculum? What goals do you have for yourself, your school, your students by participating in the program?
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If you have attended STARBASE for multiple years, what impact do you feel the hands-on, applied math and science curriculum is having on students in higher levels of education and/or those who may be entering the workforce?
Please provide any other information or comments you would like to share with STARBASE Minnesota, Inc. - Duluth.
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