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Weitzman National Museum of American Jewish History School Programs Intake Form
Answering the questions below will help us to best prepare for you visit.
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* Indicates required question
Email
*
Your email
Desired date and time of visit
*
MM
/
DD
/
YYYY
Second choice for visit date
*
MM
/
DD
/
YYYY
Name of School
*
Your answer
School Address
*
Your answer
Contact Name
*
Your answer
Phone Number
*
Your answer
Cell Phone number for day of visitÂ
*
Your answer
Grade Level
*
Your answer
Number of Students
*
Your answer
Requested Time of Visit
*
Morning
Afternoon
Do you require a lunch room or classroom space?
*
Yes
No
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