Field Trip Request Form
Please complete the form below at least three weeks prior to your field trip.
Sign in to Google to save your progress. Learn more
Today's Date *
Teacher's Name *
Name of School *
Grade *
Number of Students *
Number of Adults/Chaperones/Teachers *
One chaperone per five students is required at the Museum.  One chaperone per four students is required at Kilchis Point Reserve
Field Trip Location *
Date of Field Trip *
Requested Time *
Example: 10:00 - 1:00  Note: The Museum is open 10:00 am to 4:00 pm
Is this your first visit? *
Overview and purpose of your visit *
Objectives *
Specify skills/information that will be learned.  What are the agenda items for this field trip?
Do you need a staff-led lesson, activity, or tour? *
If so, please describe your needs
Contact Person *
Contact Person
Contact Person *
Contact Person *
Additional Information
Special requests or questions.  Example: Special needs student's requirements.
For Official Use Only
Clear form
Never submit passwords through Google Forms.
This form was created inside of Tillamook County Pioneer Museum. Report Abuse