1.School Name

2.School Location (City, Zip Code):

3.Contact Person's Name:

4.Contact Person's Email:

5.Grade(s) of field trip participants:

6.How many students are in your group (approximately)?

7.How much time can you dedicate to this experience (an hour? half a day? full day?)

8.Which subjects are of special interest to your group? (check all that apply)

Art/Architecture/Design

Analytical/Mathematical

Engineering

Measurement/Data Analysis

Sustainability

Other (please specify)

9.Are you interested in visiting any other destinations on this fields trip? (f.ex. Hartman Rock Garden, Snyder Park, Springfield Museum of Art, Heritage Center, etc)

10.If applicable, please share a little bit about your goals for this field trip experience.