wpforms-text-logo

Name of Organization or School *

Applicant Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Has your organization or school been to the Deerassic Park Education Center in the past? *

Yes
No

If yes, date(s) of previous trip(s): *

Has your organization or school ever hosted Deerassic Park at your facility before? *

Yes
No

If yes, date(s) of previous visit(s): *

How many students/children are you expecting for this in-class visit? *

What benefits will your students receive from this classroom lecture/activity? *

What circumstances or reasons does your school district need the funding? *

How will this in-class visit integrate into your current curriculum? *

During this visit, are you looking to do just one activity (approx. 45 minutes-1 hour) or is this something you're looking to make a "field day" out of it with multiple stations going on in multiple classrooms/areas of the school where your students would be split into groups to rotate around during the school day? *

Did you have any activities in mind for this visit after looking at our In-Class Program Options List? *

Signature *

Cookie	Duration	Description
cookielawinfo-checkbox-analytics	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics".
cookielawinfo-checkbox-functional	11 months	The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional".
cookielawinfo-checkbox-necessary	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-others	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other.
cookielawinfo-checkbox-performance	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance".
viewed_cookie_policy	11 months	The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.