Outreach Inquiry

Outreach Program Inquiry Form

This an Inquiry Form Only. Your program is not officially booked until we have agreed on a calendar date and time, and payment in full has been received.

Contact Name *

Email *

School/Library/Organization Name *

Are you a Title 1 school? *

Yes

No

Street Address *

City *

Zip code *

Contact Phone *

There is a 30 person limit per program.

Expected number of Participants

Number of Outreach Programs (participants/30 max) *

Grade Levels/Age Group of Participants (Check all that apply) *

Your Program Options. Note that same day visits must be the same program. *

Bunny Buddies

Join the Insect Club

Warm & Fuzzy: Mammals

Scales & Tails

Back to the Bone

Undecided

Preferred Date:

Month *

Day *

Preferred Start time: *

Alternate or Second Date:

Month

Day

Alternate Start time:

Additional Notes or Comments: