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2. Virtual Field Trip Reservation
4. Name of School or Youth Group*
6. Contact First Name*
7. Contact Last Name*
9. School Mailing Address*
11. City*
12. State*
13. Zip Code*
15. The best phone number to reach you at*
17. What email address would you like your virtual materials sent to?*
19. Grade level of students viewing the video*

    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 (Pre-Recorded Video)*
    -- Select One --Turtle Time (K-3rd)Into the Ecozone (4th-6th)The Inside Story! Behind the Scenes Tour (7th-12th)
23. Total number of students you intend to share the video with*
    If you are sharing this video with other teachers, please also include the number of students they will show the video to.
25. Are you sharing the video with any other teachers?*

    1. Yes
    2. No, it's just for me and my students
27. Additional Teacher 1 Name
28. Additional Teacher 1 Email
30. Additional Teacher 2 Name
31. Additional Teacher 2 Email
33. Additional Teacher 3 Name
34. Additional Teacher 3 Email
36. Would you like a Zoom Q&A session?*

    1. Yes
    2. No
38. Virtual Q&A Session
    Virtual Q&A sessions are available Monday through Friday at 10:30 a.m. or 12:30 p.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. Please make sure you schedule enough time to receive and watch the video before your Q&A session.
40. First Choice Date for Q&A Session
    First Choice Date for Q&A Session
41. Time preference for Q&A session
    -- Select One --10:30 a.m.12:30 p.m.No preference
43. Second Choice Date for Q&A Session
    Second Choice Date for Q&A Session
44. Time preference for Q&A session
    -- Select One --10:30 a.m.12:30 p.m.No preference
46. Will your students be Zooming remotely, from their own devices?

    1. Yes, they have their own devices.
    2. No, we'll be Zooming from a shared device in a classroom (or multiple classrooms)
48. If you are sharing the video with other teachers, would you like the other teachers to participate in the Q&A session with you?

    1. Yes, please share the Zoom meeting invite with the teachers listed above
    2. No, they do not want a Zoom Q&A session
    3. N/A - I am not sharing with other teachers
50. Additional Comments
52. Please allow up to 5 business days to receive your virtual materials (and if applicable, confirmation of your Zoom Q&A session date and time).
Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field