Organization/School Event Street Address Event City, State, Zip Code Travel is limited to a 20-mile radius of Kennett Square, PA Contact Name Position/Title Email Address Primary Telephone Number Event Information Event Name Event Date Requests may be submitted a minimum of 3 and a maximum of 12 weeks a prior to the event. Event Type - Select -Career FairFamily NightAfter SchoolCommunity EventSTEMOther Event Venue - Select -Classroom(s)AuditoriumGymnasiumOutdoorsOther Load in Time Event Start Time Event End Time Load Out TIme Event Confirmation Deadline Provided by Organization/School 6 foot table 8 foot table Chairs Electrical outlets Refreshments Student Information Age/Grade Level(s) Number of participants expected Additional Information Additional Information What code is in the image? Enter the characters shown in the image.