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 Education Program Reservation

Please complete and send one reservation form for each group requesting a program. One program per day is offered at Thomas Stone NHS with 45 students maximum per program. Each program is approximately 1.5 to 2 hours in length. Programs are offered on Wednesdays, Thursdays and Fridays throughout the school year.

School Name:

Teacher Contact:

School Address:

City:   State: Zip Code:

Telephone:  

eMail:

Best Time to Contact Teacher:  

Grade(s) Participating:

Number of Students:  Number of Adults:

Any Special Student Needs? (Gifted students, students with mobility, hearing, sight, or learning impairments; students who are emotionally supported; students who may have allergic reactions to outdoor environments such as farm animals, hay, tobacco, wood smoke, etc. If yes, please elaborate:

Education Program Requested:

Program Date(s) First Choice:  Dates Available

Second Choice:

Program Time:

Estimated Arrival Time:

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