Teacher First Name

Teacher Last Name

Organization Name

Organization Phone

Organization Fax

Type of Organization
Select Organization Public School Private School Community Organization Summer Camp After Care Other

Second Phone Number

Second Phone Type
Select Type Personal Cell Phone Home Phone Room Phone Other

Street Address

City

State

Zip Code

County

Email

Visitor Center Program
Kindergarten - Sensing the Sea
1st Grade - Intertidal Table Manners
2nd Grade - Growing Up Underwater
3rd Grade - Suitcase for Survival
4th Grade - Pass the Plankton
5th Grade - Cephapalooza: A Squid Spectacular
6th Grade - Salmonopolis: Salmon in our Sanctuary

Number of Classes Interested

Number of Students per Class

Number of Chaperones per Class

Please Select From the Following Program Dates: (please provide multiple dates if possible)

SPRING PROGRAMS 2012

February Availability:
February 7th, 11:45 am - 1:15 pm
February 10th, 10:00 am - 11:30 am
February 10th, 11:45 am - 1:15 pm
February 17th, 10:00 am - 11:30 am
February 17th, 11:45 am - 1:15 pm
February 21st, 11:45 am - 1:15 pm
February 23rd, 10:00 am - 11:30 am
February 23rd, 11:45 am - 1:15 pm
February 28th, 11:45 am - 1:15 pm

March Availability:
March 1st, 11:45 am - 1:15 pm
March 15th, 11:45 am - 1:15 pm
March 20th, 11:45 am - 1:15 pm

April Availability:
April 13th, 10:00 am - 11:30 am
April 13th, 11:45 am - 1:15 pm
April 17th, 11:45 am - 1:15 pm

May Availability:
May 8th, 11:45 am - 1:15 pm