JBEI Educational Visit Request Form
If you are interested in a tour, but do not have a student group, please contact Sara Harmon at
sharmon@lbl.gov
to make arrangements.
* Required
Point of Contact Name
*
Your answer
Point of Contact Email
*
Your answer
Point of Contact Phone
*
Your answer
Name of school, group, or institution
Your answer
Grade Level (check all that apply)
*
Middle School - Grades 6-8
High School - Grade 9
High School - Grade 10
High School - Grade 11
High School - Grade 12
Undergraduates - 2-year degree program
Undergraduates - 4-year degree program
Other:
Required
Number of Students
*
We cannot accommodate more than 30 students in a single visit. If you are unsure how many students you will have, you may give a range.
Your answer
Number of adult chaperones
*
Middle school students need at least 1 chaperone for every 8 students.
Your answer
Possible Date
*
MM
/
DD
/
YYYY
Possible Alternate Date
*
MM
/
DD
/
YYYY
Possible Alternative Date #2
MM
/
DD
/
YYYY
Please describe what time of day works best and any other scheduling notes about your preferred dates and times.
*
Your answer
What mode of transportation will your group be using to get to JBEI?
*
Public Transportation
Private bus or van
Driving in multiple cars
Other:
Please provide additional information about your group.
You may wish to include what your goals for the visit are and what background your group has.
Your answer
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