Old Town San Diego Foundation
2018-19 Grant Request - 4th Grade Old Town Historical and Cultural Field Learning Experience
* Required
Email address
*
Your email
School District
Your answer
Name of School
Your answer
Is this a Title 1 school?
Yes
No
School Street Address
Your answer
City and Zip Code
Your answer
Site Coordinator Name (first and last of lead teacher)
Your answer
Site Coordinator Email
Your answer
Site Coordinator Phone Number
*
Your answer
Date of Scheduled Trip to Old Town State Historic Park (trip MUST be scheduled first via email at
OldTown.SanDiegoSHP@parks.ca.gov
or phone 619-688-3362)
*
MM
/
DD
/
YYYY
Grade
4th grade
Number of Students (limit of 75 students/day)
Your answer
Number of Adult Chaperones (groups of 25 should include 2 chaperones)
Your answer
Number of Guests (Extra adults or children are discouraged and not covered by the OTSDF grant. Upon arrival, you will be required to pay the 8.00 park fee for each guest.)
Your answer
Special Considerations
Your answer
A copy of your responses will be emailed to the address you provided.
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