Domes Virtual Field Trip Request Form

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Thank you for your interest in a virtual science class with the Friends of the Domes!

For information, please visit MilwaukeeDomes.org/Learn/Youth-field-trips

INFORMATION ABOUT YOUR GROUP:

Group Type *

School Group / Classroom

Home School Group

Scout Group

Camp

Youth Group

Other:

School/Organization Name *

Address

City *

Zip Code *

Group Leader/Teacher's Name *

Group Leader's Cell Phone *

Group Leader's Work (or Other) Phone *

Group Leaders Email(s) *

Please include all adults who are attending, or who should be included in email communication, separated by commas

Administrator Email (To Send Invoice) *

Grade Level(s) of Children/Youth Attending *

1st

2nd

3rd

4th

5th

6th

Other:

Required

Estimated number of Children Attending *

Would you like to apply for a scholarship to cover the cost of your experience?

We currently have grant funding available for virtual programs. Qualification is based on the DPI School Report Card - Student Groups - Percentage of Economically Disadvantaged Students. If you choose "Yes", an FOD staff member will be in contact with you via email within the week. Please note - if you've already been contact that you've been awarded a scholarship, you may leave this question blank.

Yes - full scholarship

Yes - partial scholarship

Clear selection

Any specific learning or accessibility needs for this virtual workshop?

PROGRAMMING:

Program Experience Choice *

Pollinators, Unite!: Meet Honey B. as she explains the diversity and importance of pollinators

From Sun to Sugar: photosynthesis and how energy moves through food chains

The Science of Magic: A fun way to explain and test the scientific method

We are interested in something else (FOD will see if we can accommodate your request)

Your learning objectives for this experience (if any):

Any additional comments regarding programming or curriculum preferences?

SCHEDULING

Day of the Week Preferences

Check the day(s) that would work for your a field trip

Monday

Tuesday

Wednesday

Thursday

Friday

Morning or Afternoon Preference?

Please note that the Domes are typically less busy in the morning

Morning

Afternoon

No Preference

Clear selection

Important Time Considerations

I.e. times that definitely would work or would not work.

Specific Dates You Are Interested In Scheduling:

Please list dates separated by commas, in order of preference. Note: we may not be able to accommodate specific requests.

Is there anything else you would like us to know?

Submit

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