2016-2017 4th QUARTER PROGRAM REGISTRATION FORM - Howard B. Owens Science Center
The information submitted in the registration form will be used to schedule a date and time for your trip, as well as to communicate and update the school contacts with information. Upon a confirmed date and time, a Prince George's County Public Schools (PGCPS) bus will be reserved for ALL PGCPS unless an alternative bus company is used and communicated.

WE ARE EXEMPT FROM ADMINISTRATIVE PROCEDURE 6153 - PLEASE REFER TO BULLETIN S-14-16

An email confirmation will be sent to the 1st and 2nd contact person on the registration form. Please read all the information that is provided.
PLEASE SELECT YOUR SCHOOL
PLEASE CHOOSE CAREFULLY - SCHOOLS ARE IN ALPHABETHICAL ORDER.
SCHOOL START TIME:
Your answer
PROGRAM OFFERINGS FOR QUARTER FOUR:
IMPORTANT: PLEASE READ CAREFULLY THE MAXIMUM NUMBER OF STUDENTS FOR OUR PROGRAMS:
GRADE LEVEL:
OUR PROGRAMS ARE GRADE LEVEL SPECIFIC. PLEASE REQUEST THE APPROPRIATE GRADE LEVEL FOR YOUR STUDENTS.
NUMBER OF STUDENTS YOU ARE REGISTERING TO ATTEND:
MAXIMUM NUMBER OF STUDENTS SCHEDULED ON YOUR TRIP IS 32 UNLESS SPECIFICALLY STATED OTHERWISE.
NAME OF CONTACT PERSON:
Your answer
EMAIL ADDRESS OF CONTACT PERSON:
AN EMAIL MESSAGE WILL BE SENT TO YOU REGARDING YOUR SCHEDULED DATES.
Your answer
TELEPHONE NUMBER FOR YOUR SCHOOL:
Your answer
NAME OF 2ND CONTACT PERSON:
Your answer
EMAIL ADDRESS OF 2ND CONTACT PERSON:
AN EMAIL MESSAGE WILL BE SENT TO YOU REGARDING YOUR SCHEDULED DATES.
Your answer
YOUR SCHOOL WILL BE BILLED FOR TRANSPORTATION:
PLEASE PROVIDE US YOUR SCHOOL'S BUDGET STRAND FOR FY-17 SO WE CAN RESERVE YOUR TRANSPORTATION. WE WILL NOT SCHEDULE YOUR SCHOOL OR REQUEST TRANSPORTATION WITHOUT IT. PLEASE NOTE ONLY FOR PRIVATE SCHOOLS/HOME SCHOOL STUDENTS - TYPE IN N/A
Your answer
ANY SPECIAL NEEDS FOR YOUR STUDENTS:
Your answer
COMMENTS:
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