Reservation Information

January 21 - March 19, 2025 - Art+Activism

For grades 7-12

*NOTE: Art + Activism will run on Tuesdays and Wednesdays with timeslots at 9:30 AM, 10:00 AM, and 10:30 AM.*

--

March 25 - May 28, 2025 - Art+Story

For grades 3-6

*NOTE: Art + Story will run on Tuesdays and Wednesdays from 9:00 AM - 10:30 AM.*

Date of Requested School Visit

Please select only Tuesdays or Wednesdays

2nd / 3rd Options if requested date is unavailable

2nd - Date of Requested School Visit

Please select only Tuesdays or Wednesdays

3rd - Date of Requested School Visit

Please select only Tuesdays or Wednesdays

Timed Event Agreement

I understand that this is a timed program and commit to arrive by the agreed upon time (9:00 AM, 9:30 AM, 10:00 AM, or 10:30 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 teacher?

First TimeReturning Teacher

If returning, how many years have you participated?

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

My school is...

LAUSDCharterPrivateOther

Please type your answer below

Is your school Title One?

YesNo

How will you be arriving?

Additional Information

Do you have any multilingual learner students?

YesNo

Please describe their English proficiency level.

Do you have any students that need special accommodations?

YesNo

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.

Reservation Information

Teacher Information

School Information

Classroom Information

Additional Information