Today's Date *

Contact Information

School/Group Name *

Contact Person *

Phone *

Fax *

Address *

City *

State *

Zip Code *

E-mail address

Request Information

Age/Grade Level *

Number of classes *

Students per class *

Total number of children *

Number of adults *

Note: Field trips require a ratio of at least 1 chaperone per 6 children.

Requesting a: *

Field Trip

Learning Lab

Learning Lab/Field Trip Combination

Requested Learning Lab: *

Energy

Magnets

Estimation

Patterns, Strategies & Number Sense

Geospace

Simple Machines in
Action

KDE
(Learning Lab Only)

Wheels, Levers and Pulleys

Requested dates:
Note: KDE requires the scheduling of one 2-hour session per class each week for a three week period, Please provide additional dates.

1st choice *

2nd choice *

3rd choice

Requested arrival or program time:
See program descriptions for duration

1st choice *

2nd choice *

3rd choice

Do you want to reserve space for Lunch?