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Winter/Outreach Program Registration
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Contact Person
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School/Group
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Phone #
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Fax #
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Email
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Street Address
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City
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State
PA
NJ
Other:
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Zip Code
Your answer
Program Choice:
Choose
Farm Hand Adventure
Henrietta
Molly the Sheep
Molly/One-Room School
Hands-on-History (Food Preservation)
Hands-on-History (PA Dutch Folk Art)
Christmas Throughout the Colonies
One Room School Experience
On Site or Outreach?
Choose
On Site
Outreach
Number of Groups or Classes:
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Number of Children:
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Number of School/Camp Employees:
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Number of Adults:
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Date Requested
MM
/
DD
/
YYYY
Arrival Time
Time
:
AM
PM
Departure Time
Time
:
AM
PM
Gift Shop (April-December only)
Choose
Yes
No
Lunch on Site?
Yes
No
Submit
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