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Kind Kids Field Trip Request Form - Education
This form is the first step in scheduling your program.
Background Image:
Teacher Information
Name:
*
Phone Number:
*
Please format your phone number as (111) 222-3333
Email:
*
What grade level do you teach?
*
Number of interested classes:
*
Number of anticipated students per class:
*
Number of anticipated adult chaperones:
*
When do you want to schedule your visit?
*
For example: Fall or Winter time frame or specific dates
School Information
Is this school Title I eligible?
*
Yes
No
If yes, have your students participated in the Kind Kids Field Trip program before?
Yes
No
Will your school require assistance with the bus fee? (We will be in touch with you about this process)
Yes
No
School Name:
*
School Address:
*
Principal's first and last name:
*
School phone number:
*
In order to best meet the needs of your students, what category best describes your class?
*
ESL/EFL
GATE
STUDENTS WITH SPECIAL NEEDS
OTHER
NONE
If other, please describe:
Does this field trip complement any themes you are currently working on with your class?
*
Yes
No
If yes, which themes?
How did you hear about HSSV's Kind Kids Field Trip program?
*
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