Museum Group Visit & Field Trip Interest Form

2. 
4. Inspiring the Love of Learning through the Power of Play!
6. School/Organization*
8. School Address*
10. City*
11. State*
12. Zip*
14. Contact Name*
15. Cell Phone *
16. School Phone*
17. Contact Email*
19. 1st Choice - Field Trip Date*
    1st Choice - Field Trip Date
    Available Tuesday & Wednesday
20. Start Time*
    Start Time
    Available between 9 a.m. -2 p.m.
21. End Time*
    End Time
23. 2nd Choice - Field Trip Date*
    2nd Choice - Field Trip Date
    Available Tuesday & Wednesday
24. Start Time*
    Start Time
    Available between 9 a.m. -2 p.m.
25. End Time*
    End Time
27. Group - Grade Level or Age Range*
29. # of Kids*
30. # of Teachers/Paid Staff*
31. # of Adult Chaperones*
33. How will your group arrive?*

    1. School Bus

    1. Van

    1. Individual Cars

    1. Other
35. Will your group need a lunch reservation? NOTE: Your school may not eat inside the museum without a reservation. Spaces are limited and fieldtrips may be divided into multiple groups depending on size. Lunch space is NOT available Fridays.*

    1. Yes
    2. No
36. Are you interested in Avanti’s sack lunches for $5?*

    1. Yes
    2. No
38. Learning Labs are an in-depth, hands-on program led by a museum educator with topics that supplement what you are teaching in the classroom. Would you like to request Learning Labs for your visit?*

    1. Yes

    1. No
40. If Yes to the above question, what Learning Lab topic would you like covered?
42. Note: To assist us with minimizing duplication of records, please provide a personal address for each group contact.
44. Home Address *
45. City *
46. State *
47. Zip *
Leave This Blank:


49. 1. Receive an email copy of this form.
50. Email address

    This field is not part of the form submission.

51. Submit

* indicates a required field