REQUEST FIELD TRIP INFORMATION

Please note that filling out this form does not guarantee availability for preferred date and time requested

Name

Email

Phone

Where is your field trip taking place

At the Science Museum

Virtual

At my location (Outreach)

Which Program (s) would you like to schedule? (e.g. Animal Encounters, Beach Ecology, Etc)

Group Details

What is your group's Grade level? How many classes are taking park? How many students are in each class (Maximum 30)?

First Choice Field Trip Date

MM

/

DD

/

YYYY

Second Choice Field Trip Date

MM

/

DD

/

YYYY

School Name

School Address

Verification

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