Submitted by admin on Mon, 11/19/2012 School: * Form Submitted By * Teacher Name (s) * Principal School District Street Address: * City: * State: * - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip: * County: * Phone: * Fax Email: * Number of Student Attendees: $3.00 fee per student Grade or Age Group: Special Needs: Type of Tour Requested: Artful Animals Asia Explorers Design Thinking Art and Culture ArtAccess-VSA Tour Special Exhibition Tour Exhibition Interpreter in-person classroom visit Exhibition Interpreter Zoom Into Your Room Studio Activity Requested: Yes In Studio Art to Go Please note: In Studio or Art To Go Dates Requested:Tours are conducted on Wednesdays, Thursdays, and Fridays at 9:30 and 11:30 a.m. Fill in preferred dates and select desired times below. First Choice Date: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 time: 9:30 a.m. 11:30 a.m. Second Choice Date: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 time: 9:30 a.m. 11:30 a.m. Third Choice Date: Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20222023202420252026 time: 9:30 a.m. 11:30 a.m. Scholarships: % To apply for scholarship funds, indicate the percentage of students who receive subsidized lunches