New Issue for STEM Education Program Inventory

Title of Program*
Requestor Contact Information
First Name*		Last Name*
Phone Number*		E-mail*
Fax Number		Institution Name
Program Description*

Issue Information
Leading Organization*
Location of Program / Event
Program Address
Program Website
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Type of Program (if Other, enter information in the box to the right.)*	Workforce Development Student Programs Public Engagement in Life Long Learning Teacher/Faculty Prefessional Development Other			Type of Program (Other)
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Subjects Covered*	Biology Chemistry Computer Science Earth Science Engineering Environmental Science General Science Manufacturing Math Physics Robotics Space Technology Other
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Grade Level*	Elementary School (K-6th grade) Middle School (7-8th grade) High School (9-12th grade) Undergraduate Graduate Professional Development Lifelong Learners
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Area's Served (if other, enter information in the box to the right.)*	Los Alamos Mora Rio Arriba San Miguel Santa Fe Taos All New Mexico Nationwide Other			Other Areas Served
What is the number of individuals served by the program per fiscal year?*
What are the primary outcomes that the program is intended to generate?*
Year Program Started?
What is the approximate cost of the program?*
What is the cost per participant?*
What other organizations / Partnered with this program?
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Has the program been developed for and specifically target any particular diversity group(s)? If so, which one(s)?	American Indian and/or Alaskan Native Asian and/or Pacific Islander Black and/or African American Hispanic and/or Latino All Racial/Ethnic Minority Groups Women and/or Girls Individuals and Disabilities Veterans Economically Disadvantaged