1. Teacher/organizer name
2. School/organization name
3. School/organization address
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
4. Phone
(###)
###
####
5. Email
6. Preferred contact method (check all that apply)
7. Number of students
8. Grade level(s)
9. Preferred dates for program (Please provide at least three options and rank them with #1 being the date you'd most prefer for a program.)
10. Preferred program time (morning or afternoon, or more specific if applicable)
11. What program are you interested in? Pick one. (Descriptions of each program can be found by exploring the Education Programs page.)
12. For on-site programs: Will the group need a space to eat a bagged lunch?
13. For on-site programs: How will your group be getting to the Museum?
14. Accessibility needs: What do we need to know to make the experience accessible to all attendees?
15. Financial Assistance: Would you like to request one or both of the following types of financial assistance? (Please note that assistance is provided on a first-come, first-served basis, with eligibility determined by several factors.)
16. Additional information: If this visit is connecting to a larger lesson plan or unit, tell us a little about it so we can work to adapt the experience to your needs.
17. Would you like to schedule a phone call with Nick Conte, Education and Tours Manager, to discuss any of the above information before your program?
18. If yes, what are some days and times that generally work for you?
