LTP Educational Technology Registration Form

Thank you for your interest in this site. By registering to provide this CD-ROM to your school or other learning center you are helping to expand student interest in science and engineering-related careers. This registration form is intended for use by adults associated with a formal or informal learning institution (such as a museum or science center). The first 1,600 registrants on this site will be mailed a pre-release copy of "Exploring the Internet with NASA - A Snapshot of Educational Technology 2000-2001" The CD includes hot links to a variety of NASA Educational Technology offerings. Please share this CD-ROM wherever you see the need for educational technology. We'd also like you to comment on what you find and how you use it. Based on the initial feedback additional copies may be distributed to registrants at a later date, so encourage others to register on this site as well. Comments (but not registrations) may be sent to learnb@mail.arc.nasa.gov

1. Name of School or Organization:

2. Street Address:

3. City: 4. State: 5. ZIP:

6. Your First Name: 7. Your Last Name:

8. Your Phone: 9. Your E-mail:

10. Your association with the above (Parent, Teacher, Principal, Curator, Other)

Optional Information

11. District Name*:

12. Grade(s)*:

13. Number of Students*:

14. Additional contact information, including foreign addresses or phone number (DOD and others).*:

15. Comments*:

* - optional field.

Thank you for your interest.

This form can be read by standard text readers.

"This site is operated by NASA's Learning Technologies Project.  Our goal is 
to inform, inspire and involve people in the excitement of science and
space exploration.  While we develop and encourage interactivity in
learning, we strive to ensure the online safety and privacy of our
users.  NASA LTP is committed to complying fully with
the Children's Online Privacy Protection Act of 1998 (COPPA).  Notice of our
information practices are explained below as required by the Federal Trade
Commission's Children's Online Privacy Protection Regulations, located at 16
CFR § 312. Please note that only information submitted by adults is requested.

Purpose of information collected

This information is being collected to establish a mailing list for the CD- 
ROM and create a current contact list for other CD-ROMS and updates on later 
NASA Educational Technology offerings.  The frequency of these mailings is 
currently planned on an as needed basis, not expected to exceed one or two 
times a month. There are no costs associated with this content or mail list 
(although outside links may have their own costs). 

How is the information collected is used

Only the information collected on the form is retained for future use. The 
information will not be provided to parties outside of NASA LTP. You may 
remove yourself from the list by sending an e-mail with your name and the 
word "remove" in the subject block to learnb@mail.arc.nasa.gov 

Responsible parties

The responsible government official is Mark Leon and the site is operated by 
Tom Dyson. Inquiries may be sent to learnb@mail.arc.nasa.gov

Links to External Sites:

NASA LTP tries to provide a safe, fun, and private environments to learn 
about space and science.  We may link to other sites for the convenience of 
our customers.  We are not responsible for the content or collection 
practices of these sites and recommend you read their privacy policies before 
providing them information.