AstroEdge | Edge Orbit University/College Team

For best results, please set aside time to complete this form in one sitting. Progress cannot be saved to return later.

University/College Details

Primary Contact Name

Title & Role

If you are a professor, please share what you subject you teach

This address will receive a confirmation email

Phone Number

Address

Country

College/University Name

University/College Website

Faculty Captain Name (if different then above)

Faculty Captain Email

This address will receive a confirmation email

Logistics & Visibility

What is your school mascot

Upload your school logo (high resolution png or jpeg file)

Upload (8MB)

Media release consent (this provides consent for every student on your team)

I grant permission for photos or video to be used for program purposes I do not grant permission

Edge Operator Information (Student Registration)

Edge Operators and Faculty Captains receive a range of benefits once onboarded. To ensure a timely and complete onboarding process, please provide all requested information so we can:

Expedite onboarding and approval

Grant appropriate technical access and system credentials

Coordinate physical materials, credentials, and on-site benefits

Ensure all Edge Operators receive their full entitled benefits without delay

If you prefer, you may upload your responses here OR you can type them in the question box below: If you prefer, you may upload your responses here OR you can type them in the question box below: For each student share the following information (failure to share all info may slow down your onboarding): 1) Student Full Name, 2) Student Email, 3) Address, 4) Phone Number, 5) Current Grade Level - Freshman -Sophomore -Junior -Senior -Graduate Student, 6) Student Major

Upload (8MB)

If you prefer, you may upload your responses here OR you can type them in the question box below: For each student share the following information (failure to share all info may slow down your onboarding): 1) Student Full Name, 2) Student Email, 3) Address, 4) Phone Number, 5) Current Grade Level - Freshman -Sophomore -Junior -Senior -Graduate Student, 6) Student Major

Payment

Please note, there are two easy ways to process your payment:

1. Mail in payment $5,000.00 made payable to Space Grove (4725 N Courtenay PKWY, Merritt Island, FL 32953, please print form and include with your payment)

2. Credit/Debit - includes a processing fee, $5,250.00

Please pay careful attention to the payment options below to process appropriately. Thank you in advance.

Please contact Space Grove with questions.

I will make my payment via, please check your method of payment:

Debit/Credit + Processing Fee ($5,250.00) Mail in Payment (Please include form; 4725 N Courtenay PKWY, Merritt Island FL, 32953

Credit/Debit Payment/Enter $5,250.00 to check out

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

Please fill out this form and click submit.

AstroEdge | Edge Orbit University/College Team

Description

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