Book your Burke Live! program with the Burke Museum
Ready to get started? Complete the form and we'll be in touch to go over your request. Also, please note that all requests must be submitted two (2) weeks prior to the requested program date.
Questions?
Call us at 206.543.5591 or email burked@uw.edu, Monday–Friday, 8 AM – 5 PM
.
CONTACT INFORMATION
First Name
Last Name
Email
Phone
Phone type
Please select...
School/Organization
Home
Cell
Alternate Phone
Alternate phone type
Please select...
School/Organization
Home
Cell
SCHOOL, ORGANIZATION, OR GROUP INFORMATION
Please tell us a little more about who the program is for.
What type of organization are you with?
Please select...
School
School District
Home School
Nonprofit
Other (please describe)
Other organization type
School District name (if applicable)
School, organization, or group name
What is your role within the organization (teacher, parent, etc.)?
Is there anything about your class that we should be aware of? (Examples include: ADA requirements, special accommodations.) If so, please explain in detail.
COST ASSISTANCE REQUEST?
Our generous donors make it possible for us to offer cost assistance to eligible schools across the state. Will you be applying for cost assistance?
No
Yes
COST ASSISTANCE INFORMATION
Needs-based cost assistance is available on a first come, first served basis. Please provide as much of the following information as possible to help us evaluate your cost assistance request.
Percentage of student population eligible for the National School Lunch program:
%
Describe the student population demographics, including race/ethnicity:
Please indicate how much of the total program fee your class/organization can pay. If you cannot pay any part of the fee, please type in 0: $
* Please note: Burke Live! Programs cost $90 for one 45-minute program, maximum of 35 students.
Please select any of the following additional criteria for financial assistance consideration that apply to your school or organization.
Nonprofit organization with limited budget for educational resources
Budgetary concerns or financial hardship
Tribal schools and affiliated groups
Organizations that serve students from low income areas
Cultural organizations that support immigrant youth and/or youth of color
Please tell us why it would be challenging for your group to pay the full cost of this program, and how the program would benefit your group.
BURKE LIVE! PROGRAM SELECTION
Burke Live! programs are available Monday–Friday.
Please note: During the summer months (July - August), Burke Live! Programs can be booked on Wednesdays and Thursdays only.
Please select your preferred date and time for the program:
Date
Time:
Please select...
9:00 AM
10:00 AM
11:00 AM
12:00 PM
1:00 PM
2:00 PM
3:00 PM
Please list alternate dates and times in the event your preferred option is unavailable:
Please select from the following topics for your virtual program:
Dinosaurs (PreK-1st)
Ecosystems (PreK-1st)
Ecosystems (2nd-8th)
Coast Salish Cultures (2nd-8th)
What age group(s) will participate in this program?
Early Learners (Pre-K–Grade 1)
Elementary (Grades 2–5)
Middle School (Grades 6–8)
What grade level(s) are your Early Learner students?
Pre-K
Kindergarten
1
How many students (Pre-K–Grade 1) will participate?
(Please note that each 45 minute program can accommodate one class of up to 35 students. Multiple back-to-back sessions will be scheduled if more than 35 students are participating.)
What grade level(s) are your Elementary students?
2
3
4
5
How many students (grades 2–5) will participate?
(Please note that each 45 minute program can accommodate one class of up to 35 students. Multiple back-to-back sessions will be scheduled if more than 35 students are participating.)
Which grade level(s) are your Middle School students?
6
7
8
How many Middle School students (Grades 6–8) will participate?
(Please note that each 45 minute program can accommodate one class of up to 35 students. Multiple back-to-back sessions will be scheduled if more than 35 students are participating.)
VIDEO CONFERENCING
The Burke Educator will join your class via the video conferencing platform you use with your students. What video conferencing platform will you be using for the program?
Zoom
Microsoft Teams
Skype
Google Hangouts Meet
Other (Please specify below)
Other video conferencing platform:
As the client, you will host a video conferencing meeting that you will invite the Burke Educator to join. The Burke Educator will be a guest speaker during the meeting and is not responsible for monitoring student behavior. You, as the host, must be present at all times during the meeting, and are responsible for the students. It is your responsibility to inform guardians that students will be participating in a video conferencing session with an Educator from the Burke.
I understand and agree to the above statement
Please click "Submit" when you're ready to complete your request. We'll follow up within three (3) business days to go over your request with you and provide more information.
Contact Information