1.0 Group Leader Interest Form
Group Leader Interest Form
Organization Name
Group Type
Please select...
College/Univ
Community
Corporation
Government
K-12
Non-profit
Other
Religious
Grade Level
Please select...
Preschool - Kindergarten
1st - 4th
5th - 8th
9th - 12th
Phone
Organization Address
City
State
Please select...
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Postal Code
Group Leader Contact Information
First Name
Last Name
Email
Cell Phone
If you do not have a cell phone number, enter in another phone number unique to you.
Volunteering Request Details
Total # of Volunteers Anticipated
Anticipated Number of Chaperones
** Please note that we are currently scheduling group visits for July 1, 2019 and beyond. **
Date Request - 1st Choice
Date Request - 2nd Choice
Date Request - 3rd Choice
Location Preference
Please select...
North Grafton (04/29 thru 11/01)
Harvard (9/1 - 10/15 M,T,W,F 9-12 only, groups of up to 30 participants per day)
Notes/Special Requests
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