Field Trip Request Form

For additional group options and customizations please reach out to us directly at ccuribado@kenosha.org

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Phone

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Group Type*

School

Home School

Adult Group/Organization

Daycare

We Come To You

Organization/School Name*

Address*

Street Address City State ZIP Code

Group Leader Name*

First Last

Email*

Phone*

Grade Level of Group*

If multiple groups, select "various ages"

Various Ages (please provide context in notes at end of form)

PreK

1st Grade

2nd Grade

3rd Grade

4th Grade

5th Grade

6th Grade and up

Number of*

One adult chaperone is required for every 8 children

Students

Teachers

Chaperones

Number of Adults*

Adults

Staff

Museum (check all that apply)*

Kenosha Public Museum

Civil War Museum

Dinosaur Discovery Museum (Mondays preferred)

Museum (check all that apply)*

Kenosha Public Museum

Dinosaur Discovery Museum

Museum of Interest*

Kenosha Public Museum

Civil War Museum

Dinosaur Discovery Museum

Topic of Interest or Theme:*

Group Age Levels:*

Which Kenosha Public Museum program(s) are you interested in taking?*

Highlights Tour

Museum Explorers

Which Kenosha Public Museum program(s) are you interested in taking?*

Highlights Tour

Museum Explorers

Which Kenosha Public Museum program(s) are you interested in taking?*

Highlights Tour

Museum Explorers

Which Civil War Museum program(s) are you interested in taking?*

Midwest in the Civil War Tour

Which Civil War Museum program(s) are you interested in taking?*

Midwest in the Civil War Tour

Which Civil War Museum program(s) are you interested in taking?*

Midwest in the Civil War Tour

Mr. Lincoln's Army

Which Civil War Museum program(s) are you interested in taking?*

Midwest in the Civil War Tour

Mr. Lincoln's Army

Which Civil War Museum program(s) are you interested in taking?*

Midwest in the Civil War Tour

Mr. Lincoln's Army

Which Civil War Museum program(s) are you interested in taking?*

Midwest in the Civil War Tour

Which Dinosaur Discovery Museum program(s) are you interested in taking?*

Dinosaur Highlights

What is a Dinosaur?

Which Dinosaur Discovery Museum program(s) are you interested in taking?*

Dinosaur Highlights

What is a Dinosaur?

Which Dinosaur Discovery Museum program(s) are you interested in taking?*

Dinosaur Highlights

What is a Dinosaur?

Which Dinosaur Discovery Museum program(s) are you interested in taking?*

Dinosaur Highlights

What is a Dinosaur?

Which Dinosaur Discovery Museum program(s) are you interested in taking?*

Dinosaur Highlights

What is a Dinosaur?

Which Dinosaur Discovery Museum program(s) are you interested in taking?*

Dinosaur Highlights

What is a Dinosaur?

Which Dinosaur Discovery Museum program(s) are you interested in taking?*

Dinosaur Highlights

Which Kenosha Public Museum program(s) are you interested in taking?*

Highlights Tour

Animal Adaptations

Which Kenosha Public Museum program(s) are you interested in taking?*

Highlights Tour

Animal Adaptations

Native American Lifeways

Which Kenosha Public Museum program(s) are you interested in taking?*

Highlights Tour

Animal Adaptations

Native American Lifeways

Which Kenosha Public Museum program(s) are you interested in taking?*

Highlights Tour

Animal Adaptations

Native American Lifeways

Which Kenosha Public Museum program(s) are you interested in taking?*

Highlights Tour

Anishinaabe

Mammoth Mystery

Which Kenosha Public Museum program(s) are you interested in taking?*

Highlights Tour

Anishinaabe

Mammoth Mystery

Which Kenosha Public Museum program(s) are you interested in taking?*

Highlights Tour

Anishinaabe

Mammoth Mystery

Which Civil War Museum program(s) are you interested in taking?*

Midwest in the Civil War Tour

Voices of Freedom

Which Civil War Museum program(s) are you interested in taking?*

Midwest in the Civil War Tour

Voices of Freedom

Dinosaur Discovery Museum Program*

Dinosaur Highlights

Dinosaur Discovery Museum Program*

Dinosaur Highlights

Dinosaur Discovery Museum Program*

Dinosaur Highlights

Dinosaur Discovery Museum Program*

Dinosaur Highlights

Kenosha Public Museum Program*

Highlights Tour

Kenosha Public Museum Program*

Highlights Tour

Which Civil War Museum program(s) are you interested in taking?*

Midwest in the Civil War Tour

Technology through Time

Voices of Freedom

Dinosaur Discovery Museum Program*

Dinosaur Highlights

Additional Classroom Activities for Midwest in the Civil War Tour (not required)

Freedom Narratives

Building Bridges

On the March

Resource Center

Additional Classroom Activities for Midwest in the Civil War Tour (not required)

Freedom Narratives

Building Bridges

On the March

Resource Center

Additional Classroom Activities for Midwest in the Civil War Tour (not required)

Freedom Narratives

Building Bridges

On the March

Resource Center

Additional Classroom Activities for Midwest in the Civil War Tour (not required)

Freedom Narratives

Building Bridges

On the March

Resource Center

Additional Classroom Activities for Midwest in the Civil War Tour (not required)

Freedom Narratives

Building Bridges

On the March

Resource Center

Additional Classroom Activities for Midwest in the Civil War Tour (not required)

Freedom Narratives

Building Bridges

On the March

Resource Center

Additional Classroom Activities for Midwest in the Civil War Tour (not required)

Freedom Narratives

Building Bridges

On the March

Resource Center

Additional Classroom Activities for Midwest in the Civil War Tour (not required)

Freedom Narratives

Building Bridges

On the March

Resource Center

Additional Classroom Activities for Midwest in the Civil War Tour (not required)

Freedom Narratives

Building Bridges

On the March

Resource Center

Kenosha Public Museum Program Add-ons (optional)

An additional fee is required

The Science of Owl Pellets

Print Making Lab

Kenosha Public Museum Program Add-ons (optional)

An additional fee is required

The Science of Owl Pellets

Print Making Lab

Kenosha Public Museum Program Add-ons (optional)

An additional fee is required

The Science of Owl Pellets

Print Making Lab

Civil War Museum Program Add-ons (optional)

An additional fee is required

Theater Program

Civil War Museum Program Add-ons (optional)

An additional fee is required

On The March

Theater Program

Resource Center

Civil War Museum Program Add-ons (optional)

An additional fee is required

On The March

Theater Program

Resource Center

Civil War Museum Program Add-ons (optional)

An additional fee is required

On The March

Theater Program

Resource Center

Select Performance:*

Location of Theater Program*

Where would you like the theater performance to take place?

On Site During Visit

At Your Location

Virtual

Location of Theater Program*

Where would you like the theater performance to take place?

On Site During Visit

At Your Location

Virtual

Location of Theater Program*

Where would you like the theater performance to take place?

On Site During Visit

At Your Location

Virtual

Location of Theater Program*

Where would you like the theater performance to take place?

On Site During Visit

At Your Location

Virtual

Location of Theater Program*

Where would you like the theater performance to take place?

On Site During Visit

At Your Location

Virtual

Location of Theater Program*

Where would you like the theater performance to take place?

On Site During Visit

At Your Location

Virtual

Location of Theater Program*

Where would you like the theater performance to take place?

On Site During Visit

At Your Location

Virtual

Location of Theater Program*

Where would you like the theater performance to take place?

On Site During Visit

At Your Location

Virtual

Additional Ammenities

An additional fee is required

Lunch Space (not available at Dinosaur Discovery Museum)

Streetcar

Select Coffee & Conversation Topic (if applicable)

Artists and their Gardens

Wisconsin's Own: Frank Lloyd Wright

Anishinaabe History and Culture

Select Coffee & Conversation Topic (if applicable)

Medicine of the Civil War

Civil War Innovation and Technology

The Legacy of Civil War Monuments

Life of the Civil War Soldier

Playing the Part with Mary Kababik

Select Coffee & Conversation Topic (if applicable)

Bone Wars

What Jurassic Park Got Right

What Is a Dinosaur?

Field Trip Date (Choice #1)*

Please choose three separate dates so we can best accommodate your group. 9:30am is the earliest arrival time available. If interested in the Dinosaur Discovery Museum, Mondays are preferred.

MM slash DD slash YYYY

Arrival Time (Choice #1)*

Hours

Minutes

AM/PM

Departure Time (Choice #1)*

Hours

Minutes

AM/PM

Field Trip Date (Choice #2)*

MM slash DD slash YYYY

Arrival Time (Choice #2)*

Hours

Minutes

AM/PM

Departure Time (Choice #2)*

Hours

Minutes

AM/PM

Field Trip Date (Choice #3)*

MM slash DD slash YYYY

Arrival Time (Choice #3)*

Hours

Minutes

AM/PM

Departure Time (Choice #3)*

Hours

Minutes

AM/PM

Please provide additional information about your group:

What is seven plus one?*

Just making sure you're a real person!

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Kenosha Public Museum Programs

Civil War Museum Programs

Dinosaur Discovery Museum Programs

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Kenosha’s natural sciences and fine and decorative arts museum

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The Civil War from the perspective of the people of the 7 states of the upper mid-west

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The only museum to focus on the link between meat-eating dinosaurs and birds.

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