Forms & Logs


              SIGN-UP FORM

What Are You Doing After School? How About Something Different...

You are invited to participate in an exciting new project entitled, Imagination Place! We are just beginning to create this project and we are looking for kids ages 8 - 12 try out activities that will be a part of the Imagination Place! online world. We hope you will be able to join us!

The staff of Imagination Place!

For teachers: If you want to print and submit a copy of this form instead, please feel free to use this print version (which requires the Adobe Acrobat Reader) or print this page in the web browser (select "Print" in the "File" menu).


     Password:

1) Your name:

2) Your age:

3) Your phone number:

4) Your email address:
   (if you have one)

5) Location of your Imagination Place! club or class (name of school or library):
   
6) Do you have access to a computer at home?     Yes     No

7) Do you have Internet access at home?     Yes     No

8) Where do you access computers the most?

    Home     School     Public Library     After School Center/Community Center
   Other

9) What are your interests/hobbies (things you like to do)?

    

10) Describe something that makes you unique or special:

    

11) Tell us about technology that you use everyday:

    

12) When you hear the word design what comes to mind?

     




Imagination Place! is a computer-based project that is being by EDC's Center for Children and Technology. For more information about this project please contact: Imagination Place!, EDC/CCT, 96 Morton Street, New York, NY, 10014. (212)807-4200.