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2. Virtual Field Trip Reservation
   All participating teachers must fill out this form individually.
4. Name of School or Youth Group*
6. Contact First Name*
7. Contact Last Name*
8. Contact Phone Number*
10. School Mailing Address
12. City
13. State
14. Zip Code
16. Email Address*
    Please use the email address you would like your materials sent to.
17. Number of students in your class*
19. Grade Level*

    Include all that apply.

    1. K
    2. 1st
    3. 2nd
    4. 3rd
    5. 4th
    6. 5th
    7. 6th

    1. 7th
    2. 8th
    3. 9th
    4. 10th
    5. 11th
    6. 12th
21. Virtual Program*
    -- Select One --Turtle Time (K-3rd)Into the Ecozone (4th-6th)The Inside Story! Behind the Scenes Tour (7th-12th)
23. Would you like a virtual Q&A session?*
    -- Select One --YesNo

    Virtual Q&A sessions allow your students to ask questions about the video program.
25. Virtual Q&A Session
    Virtual Q&A sessions are available Wed-Fri on 9:00 a.m. and10:15 a.m. Your reservation will not be completed if you select a date outside of the designated sessions. Space in these sessions is limited and your class may be combined with another class from a different school. If you wish to participate with other teachers from your school, please list their names and emails below.
27. First Choice Date for Q&A Session
    First Choice Date for Q&A Session
28. Time preference for Q&A session*
    -- Select One --9:00 a.m.10:15 a.m.No preference
30. Second Choice Date for Q&A Session
    Second Choice Date for Q&A Session
31. Time preference for Q&A session
    -- Select One --9:00 a.m.10:15 a.m.No preference
33. Participating with other teachers?*

    1. Yes
    2. No
35. Teacher 2 Name
36. Teacher 2 Email
38. Teacher 3 Name
39. Teacher 3 Email
Leave This Blank:


41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit

* indicates a required field