Out of State Field Trip Registration Form Please complete the following request for school and community group field trips. Field trips and student programs are only available for groups of 15 or more that register 14 days prior to the visit date. 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, we will verify availability and create a group reservation. We will send confirmation of that group reservation to you via e-mail within two days. If we are unable to accommodate your request, we will contact you via telephone and/or email to discuss alternatives for your group. Please note that pre-registration for field trips is required. Groups that come to the Museum without pre-registration will not be admitted. Notice: Student Program Classes are given on Monday, Tuesday, Wednesday and Thursday. If you have questions about your reservation request or would like to speak with someone in the Reservations Office, please call (312) 665-7300. * denotes Required Information. Group Leader Information Email Address (required) First Name (required) Last Name (required) Telephone School/Organization Information School/Organization Name (required) Street Address (required) City (required) State (required) - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip (required) Telephone (required) Fax (required) School Type (required) - Select -PublicPrivateOther If other, please specify, eg. Home School, Youth, Social Service or Education-based Non-Profit. Group Information Grade Level (required) DaycarePre-KKindergartenFirstSecondThirdFourthFifthSixthSeventhEighthHigh School * For Windows: Hold down the control (ctrl) button to select multiple options * For Mac: Hold down the command button to select multiple options Number of Students (required) Number of Chaperones (required) Special Needs Special Needs Chaperones Day of Visit 1st Choice (required) Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year2018201920202021 2nd Choice Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year2018201920202021 3rd Choice Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year2018201920202021 Arrival Time (required) Hour Hour9 am10 am11 am12 pm1 pm2 pm3 pm4 pm : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 Departure Time (required) Hour Hour10 am11 am12 pm1 pm2 pm3 pm4 pm5 pm : Minute Minute000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859 Museum Hours are 9am-5pm, contingent upon time of year. Last admission is at 4pm. Please check your school calendar to avoid scheduling visits on holidays or in-service days. During Your Visit Special Exhibitions require timed ticket entries. Pre-registration is required for all special exhibitions and space for each entry time is limited. Choose a Special Exhibition You Plan to Visit Ancient Mediterranean Cultures in Contact (through April 29, 2018) Mummies (March 16, 2018 - April 21, 2019) Antarctic Dinosaurs (June 15, 2018 - January 6, 2019) Underground Adventure (ongoing) Cyrus Tang Hall of China (ongoing) 3D Movie in the EY Theater (ongoing) Lunch Plan (Monday through Friday only) Lunch Plan (required) We are not staying for lunch We would like to order Bagged Lunches* We are bringing Lunch: Eat in Siragusa Lunchroom** We would like to order vouchers which can be used at The Field Bistro or the Explorer Cafe*** We are bringing Lunch: Eat on the Museum’s northwest terrace or in the Sea Mammals area (unreserved: first-come, first-served. Please bring lunches in backpacks when choosing this option. Lunches will not be held in the Siragusa Center.) *Additional cost per person, lunch space is provided for 1 hour, $75 staffing fee applies. ** A $65 Siragusa staffing fee applies. ***Vouchers available in $5, $10, and $15 denominations. A $25 administrative fee applies. Additional Comments and Terms Please tell us how you learned about teacher and student programs at The Field Museum. Direct-mail piece Website School Colleague Took a workshop at the Museum Other If other, please specify Additional Comments Incomplete applications cannot be processed and will be returned. Please allow up to two days for your registration form to be processed. Reservations are not accepted less than 14 days prior to visit. To cancel or alter your field trip plan, please e-mail firstname.lastname@example.org or fax the Museum at 312.665.7501. Any reductions in your reservation numbers or field trip cancellations need to be made 14 days prior to the scheduled visit in order to receive a refund. Groups who arrive at the museum with fewer people than were paid for at the time of the reservation will not receive a refund.Your confirmation kit will be sent via email and will contain verification of the date approved for your field trip and/or student programs. If you do not receive your confirmation kit within one week of submitting your registration form, please e-mail email@example.com or call us at 312.665.7500 as soon as possible, M-F 8:30am-4:30pm. User Agreement (required) I have read and will abide by the Museum's field trip policies and information.