School Name:
District
Address:
City
State
Zip
COORDINATOR CONTACT INFORMATION
Full Name
*
Email
*
Phone
*
TEACHER IN CHARGE DAY OF VISIT:
Full Name
Mobile Phone
Please schedule your visit at least five weeks in advance.
Please list three possible dates for your visit (in order of preference):
You will be contacted within three days of submission of this form with available date. If the group has more than 100 students, it must be divided into two visits.
# of Students:
Grade Level (grades 3 and above)
Expected time of arrival (Tours may begin between 9 am & 3 pm.):
Expected length of visit (One to 1 to 1.5 hours is recommended):
Special consideration for your group (special needs, other stops, time restraints, interests)
Means of Transportation:
Car or Van
Bus
Are all students scheduled to arrive at the same time?
Yes
No
If no, please explain: