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

20. Start Time*
    Start Time

21. End Time*
    End Time

23. 2nd Choice - Field Trip Date*
    2nd Choice - Field Trip Date

24. Start Time*
    Start Time

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 room? NOTE: Not available Fridays.*

    1. Yes

    1. No

36. Are you interested in Avanti’s sack lunches for $5?

    1. Yes

    1. 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 email copy
50. Email address

    This field is not part of the form submission.

51. Submit

* indicates a required field