2023-24 Pond Keepers Program Request Form
Please take a moment to fill out this form to let Mohonk Preserve Education Department know your interest level in the Pond Keepers program for the 2023-2024 school year. 
Connectez-vous à Google pour enregistrer votre progression. En savoir plus
Adresse e-mail *
COORDINATING CONTACT TEACHER'S INFORMATION
Please fill out the following information.
Name (And the names of any other teachers participating) *
Title/Grade level *
Email *
Daytime Phone Number *
SCHOOL INFORMATION
Please fill the following information about your school.
School Name *
School Address *
School Phone Number *
POND KEEPER PROGRAM INFORMATION
Please answer the following questions about the Pond Keepers Program for 2020-2021.
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. *
Obligatoire
Number of Pond Keepers programs requested (1 pond program serves up to 25 students) *
How many classes will participate in the Pond Keepers program? (1 pond program serves up to 25 students) *
List the amount of students in each participating class:
What floor is your classroom(s) located on? Are elevators available? This is important and helps us plan to transport our heavy program materials. 
Where is the best place for us to park and unload Pond Keeper materials?
List the physical classroom number/location of each participating class (this helps us know where to go day of programming)
Does each classroom have proximity to a sink? Please describe:
Would you like to receive any of the following additional pond keeper program materials? These materials are returned at the conclusion of your pond program 
(rest assured, at no extra charge)
Any students that may require additional accommodations?  (N/A if none)
Teaching Season *
Obligatoire
Have you participated in Pond Keepers Programming? How many years? *
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 2020-2021 school year.

Have you received a scholarship in the past?
Effacer la sélection
Would your school be able to participate in the Pond Keepers program without a scholarship?
Effacer la sélection
Would your school be able to participate if offered a partial scholarship for the Pond Keepers program?
Effacer la sélection
Briefly describe why this scholarship is needed.
Envoyer
Effacer le formulaire
N'envoyez jamais de mots de passe via Google Forms.
reCAPTCHA
ConfidentialitéConditions d'utilisation
Ce contenu n'est ni rédigé, ni cautionné par Google. Signaler un cas d'utilisation abusive - Conditions d'utilisation - Règles de confidentialité
Google Forms