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Auerfarm Field Trip Request
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* Indicates required question
Email
*
Your email
Contact name:
*
Your answer
Lead Teacher Name (if different than above)
Your answer
Lead Teacher Phone Number
Your answer
School/Organization:
*
Your answer
Address:
*
Your answer
Town
*
Your answer
Telephone:
*
Your answer
What program do you wish to schedule?
*
Choose
Farms Produce Food - Spring through Fall
Pollinator Power - Spring through Fall
Summer on the Farm - Summer
Feathers and Fur
Date of program request:
*
Choose
June 20th
June 21st
June 30th
July 5th
July 7th
July 11th
July 12th
July 14th
July 18th
July 19th
July 21st
July 25th
July 26th
July 28th
August 1st
August 2nd
August 4th
August 8th
August 9th
August 11th
August 14th
August 15th
August 16th
August 17th
August 18th
Start time of program:
*
Time
:
AM
PM
Age/Grade of children
*
Your answer
Number of children attending:
*
Your answer
Number of adults attending:
*
Your answer
Is your group eating lunch after the program?
*
Yes
No
Are there any special needs we should be aware of - allergies, wheelchairs, etc?
*
Your answer
Notes:
Your answer
A copy of your responses will be emailed to the address you provided.
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