High School Field Trip Registration
The Jordan House Museum
Saturday, November 7, 2026
2001 Fuller Road, West Des Moines IA 10:00 am - 12:00 pm
Student Name
First Name
MI
Last Name
Student Email Address (personal)
Student Phone Number (xxx-xxx-xxxx)
Student School Information
High School
Please select...
Ames High School
Ankeny Centennial High School
Ankeny High School
Carlisle High School
Central Academy
Dallas Center Grimes
Des Moines Christian
Dowling High School
East High School
Grand View Christian School
Home School
Hoover High School
Johnston High School
Joshua Christian Academy
Lincoln High School
North High School
Norwalk High School
Ogden High School
Other
Roosevelt High School
Saydel High School
Scavo High School
Southeast Polk High School
Urbandale High School
Valley High School
Valley Southwoods High School
Waukee High School
Waukee Northwest High School
If you picked "other" for High school, please enter the name below.
Graduation Year & Grade
Please select...
2027 (12th Grade)
2028 (11th Grade)
2029 (10th Grade)
2030 (9th Grade)
Age
Please select...
14
15
16
17
18
19
Demographics
Ethnicity
Hispanic/Latino
Non-Hispanic/Non-Latino
Ethnicity Unknown
Race
American Indian/Alaska Native
Asian
Black
More than One Race
Native Hawaiian/ Pacific Islander
Other Race
Unknown
White
Gender
Female
Male
Non-Binary
Other
Receive Free/Reduced Lunch
Yes
No
Refugee Status
Refugee
Not a Refugee
Refugee Status Unknown
Parent/Guardian Information
First Name
Last Name
Phone Number (xxx-xxx-xxxx)
Email
Contact Information