Ullrich Scholarship Application
Please complete form to be considered for a FREE field trip to Children's Museum of Illinois!
*Applications must be received at least 2 weeks prior to desired field trip date.
*Scholarships are awarded on a first-come, first-serve basis and are scheduled based on availability.
For any questions, please contact Abby Koester at akoester@cmofil.org
Name of School
Your answer
Address
Your answer
City and State
Your answer
County
Primary Contact
Your answer
Email
Your answer
Phone Number
Your answer
Grade
Approximate Number of Students (total for grade level)
Your answer
Approximate Number of Adults (must have at least 1 adult for 5 children)
Your answer
Percentage of students on free or reduced lunch.
How would your students benefit from a free field trip to Children's Museum of Illinois?
Your answer
Learning Lab *Please choose one
Top 3 Date Choices
Your answer
Time Preference
Submit
Never submit passwords through Google Forms.
This form was created inside of Children's Museum of Illinois. Report Abuse - Terms of Service