About Your School

To schedule your field trip, complete this form and submit it. For destination management companies please provide the visiting school information in the fields. Add the company contact information in the comments section at the end of this form.

School Name ■

School Type ■

-- Chicago Public School Private School Public School Park District Day Care/PreSchool Church Group International Homeschool After School/Youth Program Social/Community Organization Other

If Other Please Specify

Street Address ■

City ■

State ■

-- International Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

Zip Code ■

School Phone ■

School Fax ■

About Your Group

Name of Main Contact ■

Main Contact Phone ■

Main Contact E-mail ■

Number of Students ■

Illinois students free. Out of state students $6 each.

Student Grade Level ■

Select all that apply

Pre-K

Kindergarten

1st

2nd

3rd

4th

5th

6th

7th

8th

9th

10th

11th

12th

Number of Teachers ■

Illinois teachers free. Out of state teachers $7 each.

Number of Chaperones ■

We require one adult for every ten students in grade 3 and above. For groups in pre-k-2 we require one adult per five children. Each adult exceeding these ratios will be charged $7. Out of state chaperones $7 each.

Number of Classes ■

Name and E-mail of other teachers coming on this field trip:

Teacher Name

Teacher E-mail Address

Teacher Name

Teacher E-mail Address

Please identify any special needs your group might have:

Special education

ESL

Physical disabilities

Other

If Other Please Specify

Will your group be using worksheets? ■

Please have students bring clipboards and pencils if you are using worksheets.

Yes
No

Date and Time of Visit

We would like to give all groups their first choice, but it is not always possible. Groups are scheduled to enter the building every 15 minutes beginning at 9:30 a.m. Monday through Saturday and 12:00 noon on Sundays. If your requested entrance time is not available, you may be booked into the next 15-minute time slot.

1st Choice Date ■

Year / Month / Day

-- 2011 2012 2013 / -- January February March April May June July August September October November December / -- 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  

2nd Choice Date ■

Year / Month / Day

-- 2011 2012 2013 / -- January February March April May June July August September October November December / -- 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  

3rd Choice Date ■

Year / Month / Day

-- 2011 2012 2013 / -- January February March April May June July August September October November December / -- 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  

Time of Entry ■

-- 9:30 a.m. 9:45 a.m. 10:00 a.m. 10:15 a.m. 10:30 a.m. 10:45 a.m. 11:00 a.m. 11:15 a.m. 11:30 a.m. 11:45 a.m. 12:00 p.m. 12:15 p.m. 12:30 p.m. 12:45 p.m. 1:00 p.m. 1:15 p.m. 1:30 p.m. 1:45 p.m. 2:00 p.m. 2:15 p.m. 2:30 p.m. 2:45 p.m. 3:00 p.m. 3:15 p.m. 3:30 p.m. 3:45 p.m. 4:00 p.m. 4:15 p.m. 4:30 p.m.

Time of Exit ■

-- 9:30 a.m. 9:45 a.m. 10:00 a.m. 10:15 a.m. 10:30 a.m. 10:45 a.m. 11:00 a.m. 11:15 a.m. 11:30 a.m. 11:45 a.m. 12:00 p.m. 12:15 p.m. 12:30 p.m. 12:45 p.m. 1:00 p.m. 1:15 p.m. 1:30 p.m. 1:45 p.m. 2:00 p.m. 2:15 p.m. 2:30 p.m. 2:45 p.m. 3:00 p.m. 3:15 p.m. 3:30 p.m. 3:45 p.m. 4:00 p.m. 4:15 p.m. 4:30 p.m.

Additional Options

Please select the options you want included in your visit.

Lunchroom Seating ■

Available for up to grade 8

Yes
No

Sensing Chicago Children's Gallery ■

Recommended for grades 3 and 4; available in 30-minute time slots.

Yes
No

Crazy for Trains Discovery Bags ■

Recommended for pre-K groups and kindergartners.

Yes
No

In Our Own Words Audio Tour ■

Recommended for grades 6 to 12. Max number of users is 60. $2/iPod; Payment is due upon arrival.

Yes
No