Field Trip Request Form | Kenosha Public Museum

Field Trip

"*" indicates required fields

Group Type*

School

Home School

Adult Group

Daycare

Organization Name*

Address*

Street Address Address Line 2 City State ZIP Code

Group Leader Name*

Email*

Phone*

Grade Level(s) of Group*

Number of*

One adult chaperone is required for every 8 children

Students

Teachers

Chaperones

Field Trip Date (Choice #1)*

Arrival Time (Choice #1)*

Departure Time (Choice #1)*

Field Trip Date (Choice #2)*

Arrival Time (Choice #2)*

Departure Time (Choice #2)*

Field Trip Date (Choice #3)*

Arrival Time (Choice #3)*

Departure Time (Choice #3)*

Museum*

Kenosha Public Museum

Civil War Museum

Dinosaur Discovery Museum

Which program(s) are you interested in taking?

Additional Options*

Lunch Space

Streetcar

Does your group require any special accomodations?

If yes, please let us know here

What is seven plus one?*

Just making sure you're a real person!

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Name

This field is for validation purposes and should be left unchanged.