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NSCNA Educational Program Reservation Form
Use this form to request a reservation for an educational program with the Ned Smith Center for Nature and Art. **Please understand that this form is a request and must be confirmed by the Education Coordinator. You will hear from a Center representative shortly to discuss your program needs.**
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* Indicates required question
Email
*
Your email
Name (first and last):
*
Your answer
Organization:
*
Your answer
Organization address:
*
Your answer
Phone:
*
Your answer
What is your preferred method of contact?
*
Email
Phone
Please select the type of group you are making the reservation for:
Boy Scouts
Girl Scouts
Other:
Clear selection
If you have a specific program in mind, please select from the following.
There is no charge for chaperones, teachers or parents/guardians. Please select all programs you are interested in learning more about.
Animal Adaptations
Native Pollinators and Honey bees
Nature Journaling
Nature Photography
Aquatic resources
Geocaching (on-site only)
Guided nature hike (on-site only)
Owl Pellets
Tree Identification
Other:
If you would like us to develop a program specifically for your group, please list the topic below. (e.g. reptiles, migration, songbirds, etc.)
Your answer
Program location:
*
Ned Smith Center for Nature and Art, Millersburg, PA
My organization (address listed above)
Requested date (please be as specific as you can, but a range is fine):
*
Your answer
If requesting an on-site field trip, do you plan to have lunch at the Center?
*
Yes, we would like to reserve the picnic area
No
I am not requesting an on-site program
Grade/Age:
*
Your answer
Number of students or participants:
*
Your answer
Number of chaperones (if applicable):
Your answer
Have you requested programming from the Ned Smith Center before?
*
Yes, an on-site field trip to the Center
Yes, an offsite program at my school/organization
Yes, a virtual lesson
Yes, I have reserved a teaching trunk before
No
How did you hear about the Center?
*
I live locally
Word of mouth
Social media
Website
Google/internet search
Billboard
Paper advertisement
Other:
Please share any other details you would like us to be aware of here:
Your answer
A copy of your responses will be emailed to the address you provided.
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