Planetarium Field Trip Reservation Request
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Indicates required fields
School Information
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School District:
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School or Group Name:
School Address:
City:
State:
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Zip:
Contact Information
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Contact Name:
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Phone Number:
(###-###-####)
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Contact E-Mail:
(Must conform to the correct email format)
Event Information
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Grade Level:
- Select -
K
1
2
3
4
5
6
7
8
High School
College
Various (enter levels in comments field below).
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Number of Students attending:
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Number of Teachers attending:
Number of Chaperones attending:
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Show Preferred:
Select
Discover the Solar System
Can You See in the Dark (Kindergarten level show)
America in Space
Star of Bethlehem (seasonal only)
Other (enter show name in comment field below)
Preferred Date 1:
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Preferred Date 2:
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Preferred Date 3:
Time Preferred:
Select
9:30am
11:15am
1pm
Other (enter other time preferred in comment field below)
Comments, Questions, Special Needs: