2. School Name*
4. School Type*
   -- Select One --Ogden SchoolPublic SchoolPrivate/Charter SchoolHomeschoolDaycare/PreschoolChurch GroupInternationalAfter School / Youth ProgramSocial / Community Org.Other
6. School Address*
8. City*
9. State*
10. Zip Code*
12. School Phone Number*
14. Primary Contact's First and Last Name*
16. Primary Contact's Phone Number*
18. Primary Contact's Email Address*
20. Grade Level(s) of Students*
24. Booking Request
26. Total number of students you are booking programs for*

    1. 5-35 students ($70)
    2. 36-70 students ($140)
    3. 71-150 students ($300)
28. How many programs?*

    1. 1 program for all 36-70 students ($140)
    2. 2 seperate programs, each for up to 35 students ($140)
    3. 3 seperate programs, each for up to 35 students ($300)
30. Please select which program you are reserving*

    1. T is for Trains
    2. Getting Around: Transportation in Ogden Then and Now
    3. We Dig History
    4. Ogden Crossroads of the West
32. If you are booking different programs for multiple classes, which programs are you requesting for each class?*

    (ex. Class 1: We Dig History; Class 2: Getting Around; Class 3: Ogden Crossroads of the West)

    -T is for Trains
    -Getting Around: Transportation in Ogden Then and Now
    -We Dig History
    -Ogden Crossroads of the West

    
    

34. Do you prefer a 45 or 60 minute program?*

    1. 45 minutes
    2. 60 minutes
38. Date & Time of Visit
40. Please list between 3 - 5 possible dates and times when your class is available.*

    Programs can be up to 60 minutes, Tuesday - Friday, starting at 9:00, 11:00 am and 1:00pm. Program times are based on MST.

44. Additional Options
46. Special Needs

    1. Special Education
    2. ESL
    3. Physical Disabilities
    4. Other
48. Lunch Room Seating

    1. Yes
    2. No

    Available for up to Grade 8

52. Additional Questions
54. How often do you visit Ogden's Union Station Museum for field trips?*
    -- Select One --This is our first timeOnce a school yearMultiple times during a school yearEvery few school years
56. What do you teach?*
    -- Select One --Social StudiesHistoryEnglish Language ArtsScienceTechnologyOther
58. Why are you planning this field trip?*
    -- Select One --EnrichmentPart of a unit or lessonPreparing for a history fairOther
60. What content do you hope your students gain as a result of their visit to the Museum?
62. What skills do you hope your students practice as a result of their visit to the Museum?
64. Any Comments or Questions?
Leave This Blank:


66. 1. Receive an email copy of this form.
67. Email address

    This field is not part of the form submission.

68. Submit

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