Requester Information Name Required First Required Last Required Email Required Phone Address Required Address Required City/Town Required State/Province Required - Select - Alabama Alaska American Samoa Arizona Arkansas Armed Forces (Canada, Europe, Africa, or Middle East) Armed Forces Americas Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming ZIP/Postal Code Required Event Information Name of Event Required Location of Event Required Address Required City/Town Required State/Province Required - Select - Alabama Alaska American Samoa Arizona Arkansas Armed Forces (Canada, Europe, Africa, or Middle East) Armed Forces Americas Armed Forces Pacific California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming ZIP/Postal Code Required Date Kit(s) Needed Required Date of Event Required I request that an Entomology graduate student present the kit information. The Department of Entomology has a number of ready-made kits available for check-out that can be used to conduct your own insect programs. Required Yes No Start & End Times of Event Required Audience Ages Required Approximate Number of Participants at Event Required Please describe your event. Who is it for (e.g., school, summer camp, library, etc.) and what type of program would you like? (e.g., presentation, educational display, live insects, etc.) Required Educational Objective of your event. As a part of the University of Nebraska, our outreach programs have an educational objective. What are the educational or learning outcomes you are interested in for your event? (e.g., insect life cycles, pest mgt.)? Required I would like to check out the following kits (check all that apply): Required 1/1A: Insect Life Cycles 2: Insect Aesthetics (no lesson plan) 3: Insect Tractor Pull 4: Insect Communication 5: Be the Bee (no lesson plan) 6: Insect Basics 7: Insect Costumes and Puppets (no lesson plan) 8: Insect Stamps and Rubbings (no lesson plan) 9: Insect Collecting and Pinning (no lesson plan) 10: Compost Critters (no lesson plan) 11: Pest Scene Investigation (no lesson plan) 12: Entomology Escape 13: Insect Adaptation 14: Entomophagy (coming soon) 15: Beneficial Insects (no lesson plan) If requesting Kit 16: Live Madagascar Cockroaches, please indicate number of cockroaches requested. Leave this field blank