Group Visitation Registration Form

2. Date of Initial Contact*
   Date of Initial Contact

3. You must fill out one form per date of visit.

   You must fill out one form per date of visit.

5. Group Name*

6. Date of Visit*
   Date of Visit

7. Day of Visit*
   -- Select One --MondayTuesdayWednesdayThursdayFriday

9. Contact Person*

10. Email*

12. Phone Number*

13. Phone Number Day of Visit*

15. Address1*

16. City*

17. County*

18. Zip*

20. Grade or Age Level*

21. Number of Children*

22. Number of Classes*

26. Choose up to five 1/2 hr. programs

    Choose up to five 1/2 hr. programs

28. Program Selection 1*

29. Program Selection 4

31. Program Selection 2

32. Program Selection 5

34. Program Selection 3

35. Preferred time to start if not at 10:00 a.m.
    Preferred time to start if not at 10:00 a.m.

39. Check all that apply*

    1. Check to schedule a 30 minute lunch break
    2. Check to schedule a visit in the Museum Store
    3. Check if your school is title one

40. Do you have wheel chairs coming?*

    1. Yes
    2. No

41. If yes, how many wheelchairs?

Leave This Blank:


42. 1. Receive an email copy of this form.
43. Email address

    This field is not part of the form submission.

44. Submit

* indicates a required field