Summer Workshop Form - The Durham Museum : The Durham Museum

SUMMER WORKSHOP FORM

School/Organization Name*
Address*
Main Contact Name*

First

Last
Phone for Main Contact*
Email for Main Contact*
'Day of' Contact
Cell Phone for ‘Day of’ Contact*
"Day of' Contact Name (if different from Main Contact)

First

Last
Participant Information
Number of Students*
Grade Level*
Number of Teachers*
Number of Chaperones*
Date Requested*

MM slash DD slash YYYY
Arrival Time Requested*

:
Hours

Minutes

AM/PM
Workshop Requested*
* Please choose one for each group of approximately 25 students.
- Becoming Jane
- Architecture Adventure
- Pioneers on the Prairie
- Wheels and Rails
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