CLSE Lunar/Asteroid Traveling Exhibit Request
Request for the Loan of a Specific Exhibit
I have read and agree to the
After we receive your request, we will respond within 10 business days. We will later send you the link to the
online loan agreement
within 1-2 months before the period of the loan. Please fill it out within 10 business days of receiving the email request from us.
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About the Exhibit
Name of Requested Exhibit:
The Moon: Cosmic Decoder Ring
Treasure Hunt in Earth's Attic
Impacts: Delivering Death and Fostering Life
Storm of Asteroids
Protecting our Home
Preferred Beginning Date for Exhibit Display:
Preferred Ending Date for Exhibit Display:
Please provide an alternate contact, in the event that you are away when we ask you to fill out the online loan agreement.
Location Exhibit will be Displayed
Name of Building:
Room Name or Number, if any:
Type of Organization:
Other. Please describe:
Please estimate your audience diversity:
How would you classify your community?
How would you classify the community income level?
Do you plan to have other activities related to the exhibit display? If so, what? (e.g. related resource display, family programs, childrens' programs, night viewing ...)
LPI has very little funding currently to support shipping the exhibits. Please select which way you would like to cover the shipping:
I will provide credit card information in the online loan agreement that will be charged $100 to help cover shipping costs.
I will provide my organizations FedEx account information for LPI to use to ship the exhibit to me. I understand that LPI cannot estimate what my shipping charges will be.
I will pick up and return the exhibit in person.
My organization is financially unable to support the shipping costs for this loan request.
Please provide additional information regarding your need:
How did you learn about these traveling exhibits?
the Explore! library program
email from colleague
other (please describe)
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If you see an error message, please correct and resubmit.