"A Journey Through Time" Program Registration 2016/17
Welcome! Two classes from the same school may register for the same day at one time.

Please have the following information ready:

1. Teacher name(s), e-mail address(es), school address, phone number, class size(s), and information about special needs for you group.

2. A preferred date and alternate date for your trip.

3. Whether you would like to visit the Museum Store, and/or whether you would like to have a picnic on museum grounds.

4. If you plan to apply for a bus stipend. If yes, you will need to fill out and return a bus stipend application and W-9 form. You can download these forms on our website at www.homesteadmuseum.org/schools.

School Name *
Your answer
School District *
Street Address of School *
Your answer
City, State, and Zip code of School *
Your answer
Daytime Phone Number *
Your answer
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