GCC Science Center Reservation Form

Please correct the fields below:

Please correct the field(s) marked in red below:

School and District Information

Your School:

Your District:

What is the address and phone number of your school?

Address:

Phone number:

What is the name, cellular phone number and email address of the lead teacher for this visit?

Lead teacher name:

Cell phone:

Email address:

List additional teacher name(s) and email(s)

Additional teacher#1 name:

Additional teacher#1 email:

Additional teacher#2 name:

Additional teacher#2 email:

When would you like to come? (Note:Please check the calendar first )

Date: (mm/dd/yyyy)

In the case of a large group requiring two separate visits, please indicate the second date here:

Second Date: (mm/dd/yyyy)

About Your Group

How many students are you bringing?:

How many adults:

From what grade(s) are the students?:

What planetarium presentation and science activity would you like to have?

Presentation:

Activity:

Does your group need any special consideration?

If so, please describe:

Will you come by bus, cars, or by walking?

Bus

Cars

By walking

Will you be having lunch here?

Yes

Will you have cars needing "visitor" parking passes?

How many passes?

To receive a copy of your submission, please fill out your email address below and submit.
Email Address