Field Trip Inquiry

School Name*

School Phone*

Address Line 1*

Address Line 2

City*

State*

Zip*

Group Coordinator

Name*

Email*

Phone*

Group Escort (if different than group coordinator)

Name (if different than coordinator)

Phone

Group Information

Grade*

Number of Students*

Number of Chaperones*

Please note: One chaperone is required for every 10 students; must be 21 or older.

Date of Visit

First Choice

Date*

Arrival Time*

Departure Time*

Second Choice

Date*

Arrival Time*

Departure Time*

Third Choice

Date*

Arrival Time*

Departure Time*

Programs of Interest (select one or more)

Special Exhibitions (additional fees may apply)

GUITAR: The Instrument That Rocked the World [January 18-April 21, 2013]

Amazing Butterflies [May 25-September 3, 2013]

Lunch

Will your group eat lunch at the Springfield Museums?
Yes No

Special Requirements or Notes

Additional Information

Please tell us about your group so we can better plan your tour:

* Required

Springfield Museums

Featured Events

Museums à la Carte Lecture

Worn to be Wild: Opening Celebration

Docent Mini-Tour

Museums à la Carte Lecture

Docent Mini-Tour

Visit Our Store

Museum Hours

School Information

Group Coordinator

Group Escort (if different than group coordinator)

Group Information

Date of Visit

First Choice

Second Choice

Third Choice

Programs of Interest (select one or more)

Art

Social Studies & History

Technology

General Science

Physical Science

Life Science

Earth & Space Science

Planetarium Shows

Preschool Programs

Outreach Programs (instructor visits your classroom)

Special Exhibitions (additional fees may apply)

Lunch

Additional Information