Please note field trips and Museums on the Go! outreach visits require a minimum of two weeks advanced notice. Step 1 of 4 25% School InformationSchool Name*Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code School Phone*Group CoordinatorName*Email* Cell Phone*Would you like to receive Educator Text Alerts from the Springfield Museums?*YesNoExpect 3 messages regarding your field trip, plus an additional 3-4 messages per year. Message and data rates may apply. Text STOP any time to cancel. Group InformationGrade*PreschoolKindergartenFirst GradeSecond GradeThird GradeFourth GradeFifth GradeSixth GradeSeventh GradeEighth GradeHigh SchoolNumber of Students*Number of Chaperones (one chaperone required for every 10 students; must be 21+)*Date of VisitFirst Choice* Date Format: MM slash DD slash YYYY Arrival Time* : HH MM AM PM Departure Time* : HH MM AM PM Second Choice* Date Format: MM slash DD slash YYYY Arrival Time* : HH MM AM PM Departure Time* : HH MM AM PM Third Choice* Date Format: MM slash DD slash YYYY Arrival Time* : HH MM AM PM Departure Time* : HH MM AM PM Programs of Interest (Choose one or more)Art Start with Art (Ages 4-6) Eye Spy (Grades 1-2) Evolving Elements in Art (Grades 3-5) A Brush with Art (Grades 4-8) Art through the Ages (Grades 9-12) Social Studies & History Seuss in Springfield History (Grades 2-4) Native Americans (Grades 1-5) Experience Africa (Grades 2-6) Then & Now: Life at the Turn of the Century (Grades 2-4) Japan (Grades 2-6) Picturing America (Grades 3-5) History Detectives (Grades 5-8) City of Industry (Grades 6-12) Technology Building Blocks to Invention featuring Spark!Lab (Grades K-2) Physical Science Pop, Fizz, Boom! (Grades 2-4) Light and Sound (Grades 1-5) Charge It! (Grades 4-5) Forensic Science (Grades 5-8) Slime Time! (Grades 3-8) Life Science Highlights Tour (Grades K-12) Just Survive! (Grades 2-5) Scutes & Scales (Grades PreK-4) Dinosaur Discovery (Grades PreK-4) Earth & Space Science Earth Rocks! (Grades 3-6) The Amazing World of Dr. Seuss Cats, Hats and Balancing Acts (Grades PreK-K) Tons of Fun with Seuss (Grades 1-2) Seuss in Springfield History (Grades 2-4) Family Tree: Seuss and Me (Grades 3-5) Special Exhibitions (additional fees may apply) The Art of Observation: The Best of Photographer Elliott Erwitt (November 9, 2019-January 12, 2020)) Dinosaur Train: The Exhibit (February 1-May 20, 2020) Additional InformationWill your group bring lunches to eat at the Springfield Museums?YesNoWould you like to be contacted by our Blake House Cafe manager regarding boxed lunches?YesNoHow would you describe your students' learning style?Are there any sensory concerns (tactile, noise, ability to sit for a class, etc) that we should be aware of?What topics are you studying and how do they pertain to the programs and tours you have chosen for your field trip?*Is there anything else we should know about your students to ensure you have the best experience at the Springfield Museums?Accessibility/Special Requests (Student allergies, disabilities and/or mobility needs)Would you like to receive our monthly Educator E-Newsletter?YesNoHow did you hear about us?Unless otherwise noted by the visiting school educator, submitting this form gives consent to the use of photographs/videotape taken during the course of a school program visit for publicity, promotional and/or educational purposes (including publications, presentation or broadcast via newspaper, internet or other media sources).*AgreeDeclineSend me further informationThe visiting school educator does this with full knowledge and consent and waives all claims for compensation for use, or for damages. If a single student or multiple students may not be photographed, please inform the school program coordinator.