Tour Request Form
Group Name:
*
Date/Time
Date being requested:
*
Year:
*
2012
2013
2014
Month:
*
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day:
*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Hour:
*
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
Minute:
*
00
05
10
15
20
25
30
35
40
45
50
55
Alternate date 1:
*
Year:
*
2012
2013
2014
Month:
*
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day:
*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Hour:
*
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
Minute:
*
00
05
10
15
20
25
30
35
40
45
50
55
Alternate date 2:
*
Year:
*
2012
2013
2014
Month:
*
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day:
*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Hour:
*
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
Minute:
*
00
05
10
15
20
25
30
35
40
45
50
55
Program Details
Age Level:
*
College Students
Pre-K
1st - 5th grades
Middle School
High School
Adult
Type of tour:
*
Visual Literacy Tour
General Tour
Special Needs Tour
Length of tour:
*
1 hour
2 hours
3 hours
N/A
Activity request
*
Object Learning
Scavenger Hunt
None
Time for assigned activity
Number in group:
*
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31-50
51-75
76-100
101-150
Other
Tour Location Requested
(check all that apply):
*
Anderson Sculpture Garden
Art on Campus
(please specify locations in Notes)
Brunnier Art Museum
Christian Petersen Art Museum
Farm House Museum
Comments on Curiculum
Connections (tour content):
Notes:
*
Group name/affiliation:
*
Contact's first name:
*
Contact's last name:
*
Contact's Email:
*
Contact's phone:
*
Cell Phone:
Billing contact:
*