Group Request Form Group Request Form Step 1 of 4 - Organization 0% OrganizationSchool/Organization Name*Please put the full school or organization nameMain 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 Main School/Organization Phone Number*Main School/Organization Fax Number* Primary Contact InformationName* First Last Cell Phone Number*Email* Please enter full email addressAdditional Contact InformationName First Last Cell Phone NumberEmail Full email address. If more than one, separate with semicolon (;) Scheduling Information- School/Organization group rates apply to groups with a minimum of 13 students (Pre-K to 12th grade) and 2 adults. Special needs groups are not required to have a minimum number. One adult chaperone, 19 years or older, is required for every 10 students (Pre-K to 12th grade) - If you do not know the exact number of students, please use your best estimate - If you have more than one grade level visiting the museum, please add the additional grade levels on the last page in the Additional Notes sectionGrade Level*Pre-KindergartenKindergarten1st2nd3rd4th5th6th7th8th9th10th11th12thMultiple Grade LevelsCollege GroupAdult GroupSenior GroupNumber of Students*Number of Adults*Are you requesting Funding?*YesNoIf Yes, are you a Title 1 Campus?YesNoWill you be bringing sack lunches?*YesNoIf yes, please consolidate all lunches in a designated coolerPreferred date of visit1st Option* 2nd Option* 3rd Option* Preferred arrival and departure time of visitMonday through Friday earliest availability is 9 a.m. Saturday earliest availability is 10 a.m. Sunday earliest availability is 12 p.m.Arrival Time* : HH MM AM PM Departure Time* : HH MM AM PM Special Exhibition(s)Are you interested in visiting our special exhibitionYesNoIf yes, which exhibition(s) are you interested in:Ultimate Dinosaurs (May 26, 2018 to September 3, 2018)Click on the box again if you wish to select more options. School Programs- All programs are TEKS aligned, inquiry-based, hands-on and relate to students’ everyday experiences - All Student Programs and Student Experiences are subject to availability and must be reserved at least two weeks in advance Interactive Student ProgramsInteractive Student Programs are 45 minutes; presented at 9:30 a.m., 10:30 a.m., 11:30 a.m., 12:30 p.m. and 1:30 pmKindergarten to 2nd gradeDignity of Work: Water Where You Want ItDignity of Work: Trail Drive!Dignity of Work: South Texans at WorkDignity of Work: The FreighterCreature FeaturesHealthy LandFinding FossilsFood is FuelSolids, Liquids & Gases3rd to 5th gradeDignity of Work: Water Where You Want ItDignity of Work: Trail Drive!Dignity of Work: South Texans at WorkDignity of Work: The FreighterWild HabitatsTaking Care of TexasCreatures of the CretaceousOur Dynamic RiverPut Your Heart Into It!What's Hot, What's Not?4th to 7th gradeLiving off the LandPainting the PecosHands-on Archaelogy with Dr. DigGathering at the Waters6th to 8th gradeDignity of Work: Water Where You Want ItDignity of Work: Trail Drive!Dignity of Work: South Texans at WorkDignity of Work: The FreighterEco-ChallengeDeeper than DirtTexas PterosaurOur Dynamic RiverMuscle MechanicsFantastic ForcesReactions in Action9th to 12th gradeDignity of Work: Water Where You Want ItDignity of Work: Trail Drive!Dignity of Work: South Texans at WorkDignity of Work: The FreighterEnvironmental EthicsPredator ShowdownReactions in ActionFantastic ForcesClick on the box again if you wish to select more options.Extended Interactive Student Programs Extended Interactive Student Programs are 90 minutes; presented at 9:30 a.m. and 11:15 a.m.4th to 7th gradeTortillas: A San Antonio StoryClick on the box again if you wish to select more options.4th to 8th gradeFrom River to Sink, What's in My Drink?Click on the box again if you wish to select more options.Student Experiences Student Experiences are 2 hours; presented from 9:30 a.m. – 11:30 a.m.4th to 7th gradeThe Texas History Experience (Offered January 1st to July 31st)The People of the Pecos Experience (Offered June 1st to December 31st)The Super You! ExperienceThe Roots in the River ExperienceClick on the box again if you wish to select more options.5th to 8th gradeThe Dinosaur ExperienceTexas Wild ExperienceThe Roots in the River ExperienceClick on the box again if you wish to select more options.If you are interested in a Student Program, does your group need any Language Support?*YesNoIf yes, what type of Language Support does your group need:ESL (English as a second language)Hearing Impaired (Deaf, requiring sign language, etc.)Special Needs (Autistic, etc.)Click on the box again if you wish to select more options.How many students need the selected Language Support?Will there be a translator/interpreter with the group?YesNoAdditional Notes for Language Support (type of language, etc.)Please provide your email address to receive our Teacher Newsletter. (N/A if not interested)*How did you hear about us?*Educator Guide (printed)Educator Guide (website)Repeat VisitWebsite (Witte Museum)AdvertisementConferenceMailerSAISD FoundationWord of MouthTeacher NewsletterAdditional Notes By checking the box I acknowledge that filling out this form is not a confirmed reservation and is only a group request form which will be sent to the Witte Museum Reservation Team.