Reservation Information
January 31 - March 29, 2023- Art+(Re)Telling
7-12 grade
April 4 - May 31 - Art+Story
3-6 grade
* This program will run Tuesdays and Wednesdays
Date of Requested School Visit
2nd / 3rd Options if requested date is unavailable
2nd - Date of Requested School Visit
3rd - Date of Requested School Visit
Time of Requested School Visit (all times are PST)
9:00 am
Timed Event
I understand that this is a timed program and commit to arrive by 9:00 am. If you cannot attend, please cancel 48 hours in advance
Teacher Information
Is this your first time participating in the program or are you a returning class?
First Time
Returning Class
If returning, how many years have you participated?
Please select...
1
2
3
4
5
6
7
Lead Teacher's First Name
Lead Teacher's Last Name
Lead Teacher's Email Address
Contact Phone Number
School Information
School Name
School Address
School City
School State
School Zip Code
School Phone Number
TItle I School?
Yes
No
How will you be arriving
Please select...
Applying for bus scholarship (only applicable for schools within a 10-mile radius)
School bus
Carpooling
Public Transportation
Classroom Information
Which program are you selecting?
Art+(Re) Telling (7th - 12th)
Art+Story (3rd - 6th)
Number of Teachers and Chaperones
Student Information
Please enter information one grade level at a time. If you need to add an additional grade level then please click on the link "Add another response" on the bottom right. When complete please click Next Page to continue.
Number of Students
Student Grade Level
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Additional Information
Do you have any ESL students?
Yes
No
Do you have any students that need special accommodations?
Yes
No
Please describe the accommodations needed
Please provide additional information about your class, including anything that will help support the lessons you plan on providing them in relation to your visit.
Contact Information