Be added to the BurkeMobile interest list for the 2023-2024 School Year

BurkeMobile is available on a limited basis during the school year. If you are interested in hosting a BurkeMobile visit to your school or organization, please complete the form below to be added to our interest waitlist. 


Please be aware that filling out this form does not guarantee we will be able to accommodate your request. We are prioritizing schools and organizations who qualify for cost assistance and/or are geographically further from the Burke within our service area.


If we are able to accommodate a program request from the waitlist, we will reach back out to you to finalize your reservation.

Questions? Email burked@uw.edu or call 206.543.5591, Monday–Friday, 8 AM – 5 PM. 
For the quickest response, email is preferred.
CONTACT INFORMATION







SCHOOL, ORGANIZATION, OR GROUP INFORMATION
Please tell us a little more about who the program would be for.





BURKEMOBILE PROGRAM SELECTION





Please note: The maximum number of early learner students per lesson is 24. If more than 24 students, multiple lessons will need to be scheduled.







Please note: A maximum of 360 students can participate in a Mini Museum program in a single school day. If the number of students you wish to participate exceeds this number, we will need to work with you to see if it is possible to schedule the mini museum program over multiple days.


Please note: A maximum of 360 students can participate in a Mini Museum program in a single school day. If the number of students you wish to participate exceeds this number, we will need to work with you to see if it is possible to schedule the mini museum program over multiple days.
PROGRAM LOCATION & PREFERRED DATES
Where would BurkeMobile be traveling to for the program(s)?                                   






Please note: During the 2023-2024 school year, BurkeMobile is only being offered in Clallam, Island, Jefferson, King, Kitsap, Lewis, Mason, Pierce, Skagit, Snohomish and Thurston counties.

Please provide (at minimum) your first choice date for the program:                       






Please provide (at minimum) your first choice date for the program:                       






ESTIMATED PROGRAM COST
Below is the estimated cost of the program based on the information you provided and the selections you made above. This estimate is being provided for you so you can plan ahead in the event we are able to accommodate your program request from the waitlist.

Please note that the final cost may vary from this estimate once we work with you to figure out logistics for the final program. The final cost will be communicated before you will be asked to confirm you reservation.  
$
$
FINANCIAL ASSISTANCE REQUEST?
We are excited to offer financial assistance to eligible schools, programs and organizations. Wondering if you qualify? Learn more about cost assistance eligibility.

FINANCIAL ASSISTANCE INFORMATION
Needs-based financial 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 financial assistance request.

%





$












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.