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Federal Judicial Learning Center and Museum: Field Trip Form
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* Indicates required question
Field Trip Date
*
MM
/
DD
/
YYYY
Arrival Time
*
Time
:
AM
PM
Departure Time
*
Time
:
AM
PM
Organization Name
*
Your answer
My organization is a
*
Public, private, religious, or homeschool organization of 10 or greater offering students a regular course of study in accordance with the State Department of Education
Day care or summer, afterschool, or enrichment program
University, college, or GED program
Organization address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Email:
*
Your answer
Work phone
*
Your answer
Cell phone
Your answer
Contact name
*
Your answer
Number of students
*
Your answer
Number of adults/chaperones
*
Your answer
Grades
*
Your answer
May we have permission to photograph students?
*
Yes
No
Required
Are you visiting the museum to participate in a special program?
Yes
No
If yes, what is the name of the program?
Your answer
Comments or questions
Your answer
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