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Teacher name
School name
Is this a Title 1 school?
No
Yes
School phone #
School address
School town/city/ZIP
Teacher email
Teacher phone #
Type of lab
(
What labs would you like to participate in?
)
Requested month
(
Sept-June, academic year
)
June 2026
September 2026
October 2026
November 2026
December 2026
January 2027
February 2027
March 2027
April 2027
May 2027
June 2027
Requested start time
(
Between 8am-2pm Eastern
)
Grade level(s) of students
3
4
5
6
7
8
9
10
11
12
Number of students
Location
Dolan DNALC in Cold Spring Harbor
DNALC NYC
in Brooklyn
Harlem DNA Lab
Regeneron DNALC
in Sleepy Hollow
DNALC
at Passaic County Biotechnology Innovation Center
Where did you hear about us?
My school has brought classes in the past
From a coworker or supervisor
From a student or parent
From the NYC DOE or school district administration
An email from the DNALC
From an Internet search
Social Media (Facebook, Instagram, X, YouTube)
LinkedIn
Newspaper or news media
I watched a DNALC video
Send
