For Educators » Bring AZMNH to YOU

AZMNH Mobile Education Request

Font Size: + -
Press Enter to show all options, press Tab go to next option
Print

Fill out this form to request the MEAD Machine and AZMNH educators at your location


Please correct the fields below:

Field Trip Option:
 *
School or Group Name:
 *
Contact Name:
 *
Contact Address
 *
Contact Address
Email:
 *
Contact Phone:
 *
Additional Phone:

Date of Requested Visit  (mm/dd/yyyy)
Offsite education is available on Mondays and Tuesdays only.

 *
Date of Requested Visit (mm/dd/yyyy) Offsite education is available on Mondays and Tuesdays only.
Total Number of Children:
 *
Total Number of Classes Attending:
 *
Approximate Number of Adults in Group:
 *
Grade or Age Level:
 *
What type of youth organization are you representing?
 *
What type of youth organization are you representing?
Is your private group considered special needs – non-profit? (school groups leave blank)
 *
Is your private group considered special needs – non-profit? (school groups leave blank)
Are you a Title I School?
 *
Are you a Title I School?
Do any members of your group require special accommodations?
 *
Do any members of your group require special accommodations?
If answered YES to the above please explain here. 
Do you have any questions about scheduling or for our Museum Educators?
The Arizona Museum of Natural History reserves the right to reschedule MEAD Machine visits in the event of unforeseen circumstances such as staff illness, vehicle issues, or other emergencies. We will always communicate with schools as soon as possible to arrange a new date.
  1. To receive a copy of your submission, please fill out your email address below and submit.

    Page 1 / 1