Pop Up Museum Registration Form Fall 2020/ Spring 2021

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While the World Waited: Florida & the Cuban Missile Crisis

Email *

First Name: *

Last Name: *

Contact Email: *

Please make certain that your email address is correct. This our main method for contacting you about your registration.

School Name: *

Grade level of students that will be using the Pop Up Museum: *

K-2

3rd-4th grade

5th-6th grade

7th-8th grade

9th-12 grade

Required

County: *

School Mailing Address (please remember to include zip code) *

Phone Number to confirm your registration (please use the format XXX-XXX-XXXX): *

I am interested in hosting the: *

Complete Pop Up Museum (includes 8 Pop Up panels and 4 printed booklets, as well as the Virtual Pop Up Museum

Virtual Pop Up Museum only (includes the virtual exhibit and all companion materials in Google Slides/ Forms for use with Google Classroom)

I am a *

classroom teacher

media specialist

administrator

other

My FIRST choice month to host the PHYSICAL exhibit is: *

January

February

March

April

May

September

October

November & December

I ONLY want to host the virtual Pop Up Museum

My SECOND choice month to host the exhibit is: *

January

February

March

April

May

September

October

November & December

I ONLY want to host the virtual Pop Up Museum

I agree to email at least one photo of students interacting with the Pop Up Museum before the end of my host month. *

Yes

I ONLY want to host the virtual exhibit. I will submit a student work sample as an alternative.

I agree to complete and submit the Online Host Survey at the end of my host period. *

The online host survey is important to helping us understand how you use the exhibit and how we can improve future exhibits for your students.

Yes

I agree to display the physical Pop Up Museum in a secure and supervised indoor location. I will also avoid exposing the exhibit to bright sunlight or moisture. *

Yes

I ONLY want to host the virtual Pop Up Museum

I agree to save and store all shipping materials to use for shipping the physical exhibit to the next school. *

Yes

I ONLY want to host the virtual Pop Up Museum

I agree to ship the Pop Up Museum before the end of my host month using the prepaid shipping label provided by MFMM. I understand that if I miss the scheduled pickup, I will need to either bring the Pop Up Museum to a FedEx Ground store (free) OR use my personal or school account to schedule a FedEx Ground pickup to my location (a $4.00 fee applies). *

Yes

I ONLY want to host the virtual Pop Up Museum

I understand that this exhibit was created by the Mel Fisher Maritime Museum. This project was financed in part with historic preservation grant assistance provided by the Bureau of Historic Preservation, Division of Historical Resources, Florida Department of State, assisted by the Florida Historical Commission. However, the contents and opinions do not necessarily reflect the views and opinions of the Florida Department of State, nor does the mention of trade names or commercial products constitute endorsement or recommendation by the Florida Department of State. *

Yes

I understand that my reservation is NOT confirmed until I receive a confirmation email from the Mel Fisher Maritime Museum. *

Yes

Please let us know any questions you have about hosting the physical Pop Up Museum at your school.

Please let us know if you have any specific requests or concerns for using the virtual Pop Up Museum.

A copy of your responses will be emailed to the address you provided.

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