Request a BurkeMobile Visit
Ready to get started? Complete the form and we'll be in touch to go over your request. Also, please note that
all requests must be submitted three (3) weeks prior to the requested program date
.
Will you be requesting cost assistance? If so, please use
this form
to make your BurkeMobile request.
Questions?
Call us at 206.543.5591 or email burked@uw.edu, Monday–Friday, 8 AM – 5 PM
.
Applying for CA?
Yes
CONTACT INFORMATION
First Name
Last Name
Email
Phone
Phone Type
Please select...
Home
Cell
School/Organization
Alternate Phone
Phone Type
Please select...
Home
Cell
School/Organization
SCHOOL, ORGANIZATION, OR GROUP INFORMATION
Please tell us a little more about who the program is for.
What type of organization is requesting a BurkeMobile visit?
Please select...
School
School District
Home School
Library
Nonprofit
Other (please describe)
None
Other organization type
School District name (if applicable)
School, organization, or group name
What is your role within the organization (teacher, parent, etc.)?
COST ASSISTANCE REQUEST?
Our generous donors make it possible for us to offer cost assistance to eligible schools and organizations. Wondering if you qualify?
Learn more
about cost assistance eligibility.
Will you be applying for Cost Assistance?
No
Yes
COST ASSISTANCE INFORMATION
Needs-based cost assistance is available on a first come, first served basis. Please provide as much of the following information as possible to help us evaluate your cost assistance request.
Percentage of student population eligible for the National School Lunch program:
%
Describe the student population demographics, including race/ethnicity:
Is your class/organization able to pay any part of the total program fee?
Yes
No
If yes, how much?
Please select any of the following additional criteria for financial assistance consideration that apply to your school or organization.
Nonprofit organization with limited budget for educational resources
Budgetary concerns or financial hardship
Tribal schools or affiliated groups
Organizations that serve students from low income areas
Cultural organizations that support immigrant youth and/or youth of color
Please tell us why it would be challenging for your group to pay the full cost of this program, and how the program would benefit your group.
BURKEMOBILE PROGRAM SELECTION
Which program(s) would you like to request?
Programs for Early Learners -
Preschool (3+) - Grade 1
Storytellers
The Age of Dinosaurs
I Spy Science
How many Early Learners (PreK - Grade 1) will participate?
Which Early Learner Grades will participate?
Pre-K
Kindergarten
1
Mini Museum Program -
Grades 2-8 (Select only one)
Please select...
Dig In!
Living Traditions
Nature's Networks
What age group(s) will participate in this program?
Elementary (Grades 2-5)
Middle School (Grades 6–8)
How many Elementary Students (Grade 2-5) will participate?
Which Elementary Grades will participate?
2
3
4
5
How many Middle School Students (Grade 6-8) will participate?
Which Middle School Grades will participate?
6
7
8
Are there any other age groups that will participate in the program(s)? If so, please describe:
How many people in this "Other" age group will participate?
PROGRAM DETAILS
Where would you like the program(s) to take place?
Location Name (e.g. School, Community Center, Library)
Location Address
City
State
Please select...
WA
ZIP
County
Please select...
Adams
Asotin
Benton
Chelan
Clallam
Clark
Columbia
Cowlitz
Douglas
Ferry
Franklin
Garfield
Grant
Grays Harbor
Island
Jefferson
Kitsap
Kittitas
Klickitat
Lewis
Lincoln
Mason
Okanogan
Pacific
Pend Oreille
Pierce
San Juan
Skagit
Skamania
Snohomish
Spokane
Stevens
Thurston
Wahkiakum
Walla Walla
Whatcom
Whitman
Yakima
County
Please select...
King
Pierce
Snohomish
Please note: During the 2021-2022 school year, BurkeMobile is only being offered in King, Snohomish and Pierce counties.
Early Learner Date and Time Request
Looks like you're requesting an Early Learner program! Please provide the following information so we can process your request.
Number of programs needed:
Please select...
1
2
3
4
5
6
These 45-minute-long lessons are designed for a maximum of 20 students at a time. If you have more than 20 students, please request multiple programs.
Preferred Program Date
Start Time
End Time
Please provide some alternative dates and times in the event that your preferred option is unavailable.
Mini Museum Date and Time Request
It looks like you're requesting a Mini Museum program—great! Please provide the following information so we can process your request.
What type of Mini Museum experience would you prefer?
In-school experience
Community event
In-school experiences are designed for groups/classes of students. Program time will be broken into 45-minute long rotations. The Community event format is best for a STEM night, library program, or family night. This is a 2-3 hour drop-in style program.
x
Please let us know where you'd like Burke Educators to set up our interactive exhibits at the site.
Set up Location (e.g. gym, library, classroom)
Mini Museum programs require a dedicated space for the full duration of the program, 6-8 six-foot tables, at least 600 square feet of open space and access to an electrical outlet.
Preferred Program Date
Start Time
End Time
Please provide some alternative dates and times in the event that your preferred option is unavailable.
Please click "Submit" when you're ready to complete your request. We'll follow up within three (3) business days to go over your request with you and provide more information.
Contact Information