Preschool Program Request

Preschool Program Request Form

* Indicates required field

Name *

First

Last

Field Trip Date *

School *

Address *

City, State Zip *

Number of Students *

Grade Level *

Phone, include extension *

Cell Phone for day of trip *

Program - choose from drop-down menu *

Cost is $150 for a half-day program. Additional cost for butterfly plants & supplies. *

Travel room to room Have dedicated space for program

Email *

Comment, include special needs *

Submit