Teacher Name *

First Name

Last Name

Teacher Phone *

(###)

###

####

School Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Are you a Title I School? *

Yes

No

Are you interested in booking 1, 2 or 3 programs? *

1 program @ $250

2 programs @ $475

3 programs @ $700

Which Museum Explorer program(s) would you like to schedule? *

Elements of Art

Los Gatos History Project

In the Classroom | Grades 3 - 5

High School Tour

For teachers booking our 'In the Classroom' program, do you have a projection screen we can use in your classroom? *

Yes

No

Not Applicable

Have you attended a Museum Explorer program before? *

Yes

No

How did you hear about this program? *

Fellow Teacher

School Admin

Parent

NUMU Newsletter

NUMU Website

Google Search

Visiting NUMU

Social Media

Other

I understand that teachers, and chaperones for museum visits, must be present for the whole duration of the program and assist with student engagement. *

Agree

I have read, understand and agree to NUMU's Museum Explorer Cancellation Policy *

Agree