Mohonk Preserve Outreach Program Request  Form 2023-24
Libraries, schools, community centers - we take the joy of environmental learning and bring it right to you! Please take a moment to fill out this form to let Mohonk Preserve Education Department know your interest level in our various outreach programming options for 2023-24. 


Sign in to Google to save your progress. Learn more
CONTACT INFORMATION
Please fill out the following information.
Name *
Title/Grade level *
Email *
Daytime Phone Number *
LOCATION INFORMATION
Please fill the following information about where the outreach program will take place. 
Location Name *
Address *
Phone Number *
Check all the outreach programs you are interested in *
Required
Mohonk Preserve is prepared to offer in-person educator led programs if possible as well as online remote programming for the school year. Please indicate the type(s) of programs you are interested in for your class(es). Check all that apply. *
Required
Number of outreach programs requested *
Please describe how many students will participate in the outreach program. If multiple classes are participating, please note how many students are in each class.  *
Season Preference *
Required
Have you participated in outreach programming in the past? If so, which programs? *
Will you be requesting a scholarship? *
SCHOLARSHIP INFORMATION
Mohonk Preserve scholarships are typically available for schools in need, and provide full or partial support toward program fees. Our typical source of scholarship funds comes through fundraisers. Due to COVID-19’s economic impact, scholarship funds could be considerably less for the 2021-2022 school year.

Have you received a scholarship in the past?
Clear selection
Would you be able to participate in outreach programming without a scholarship?
Clear selection
Would youl be able to participate if offered a partial scholarship for outreach programming?
Clear selection
Describe why this scholarship is needed.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms