Plan a Field Trip

Full Name*

School Phone Number*

Your Contact/Cell Number*

Your Email*

What is the best time of day and number to contact you?*

School Name*

School District*

Address*

Street Address Address Line 2 City State ZIP Code

Type of education visit?*

Date (1st Choice)*

Date (2nd Choice)*

What grade levels will be in your group?*

Example: 4th and 5th graders.

Estimated number of students*

Estimated number of chaperones*

One chaperone per every 10 students is required.

What county is your school in?*

If other, what county is your school in?

Any other comments or questions?