Field Trip Form - The Durham Museum : The Durham Museum

Field Trip Request Form

Contact Information
Name

First

Last
Email
Cell Phone
School Information
School District
School or Group Name
School Phone
School or Group Type*
- Accredited Public School – K-12 Group
- Accredited Private School – K-12 Group
- Homeschool Group
- College or University
- Preschool, daycare or after-school program
- Other
* Required
If your group qualifies, are you interested in transportation funding to and from the museum?
- Yes
- No
Group Information
Grade Level
Number of Classes
Total Number of Students*

* Required
Number of Teachers/School Staff
Number of Chaperones/Non-School Staff
Any accessibility accommodations? (Type "NA" if none.)
Please indicate your group's choice date and an alternative for your field trip. We will try our best to accommodate your choice date. First Choice:

MM slash DD slash YYYY
What time would you like to arrive at the museum?

:
Hours

Minutes

AM/PM
Second Choice:

MM slash DD slash YYYY
What time would you like to arrive at the museum?

:
Hours

Minutes

AM/PM
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