www.fieldmuseum.org
Education


Outreach Program Registration Form
Please use this form for all Education Department Outreach Programs during the 2007-2008 school year.

Please complete the following request for all programs that you wish to have at your school or community center. When you are finished, click Submit to send your request to the Reservations Office. You will receive an immediate email verification of your reservation request. Once we receive your request for a program, we will verify availability and create a reservation. We will send confirmation of that reservation to you via mail within two weeks. If we are unable to accommodate your request, we will contact you via telephone and/or email to discuss alternatives for your group.

If you have questions about your reservation request or would like to speak with someone in the Reservations Office, please call 312.665.7500.

* Denotes Required Information
* Leader First Name
* Leader Last Name
* Email Address

School Information:
* School Name
* Street Address
* City
* State
* Zip
* Telephone Number
* Fax Number
* School Type
Public
Private
Parochial
Other:  
 If other, please specify, e.g. home school, youth, social service or education based non-profits
Field Ambassador School
MAPS School
*  Handicap Access
Are the school and the entrance to your classroom handicap accessible in order to accommodate our teaching carts?
Yes
No
Directions
Please provide instructions for where to park our FM vehicles.

Group Information:
* Grade Level
Daycare
Pre-K
Kindergarten
First
Second
Third
Fourth
Fifth
Sixth
Seventh
Eighth
HS
Special Needs
Please describe any special needs (e.g. wheelchair) your students may have.

Group Leader Information:
 
If you wish to be included on our mailing list to receive updates about new exhibitions and teacher and student programs, please complete the following section.
Street Address
City
State
Zip
Telephone Number
Fax Number
Email Address
 
 

 





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