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Residential Program Request Form
Please complete the information below. Requests can be made up to 12 months in advance. Be certain to provide the three best possible dates (in at least two different months) for your group to attend a Dunes Learning Center program. You will be contacted to confirm dates once school-year scheduling begins. We will do our best to accommodate your choice of dates. Your flexibility and understanding in this process are greatly appreciated.
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* Indicates required question
Dunes Learning Center program you are requesting?
*
i.e. Frog in the Bog, Winter Ecology, etc. Include season and year.
Your answer
School name
*
Your answer
School Address
*
Your answer
City
*
Your answer
State
*
IL
IN
MI
WI
Other:
Zip Code
*
Your answer
School Phone
*
Your answer
School Fax
Your answer
School Website
*
Your answer
Does your school utilize social media?
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Yes
No
Does your school have a newsletter?
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Yes
No
Lead Teacher(s) or Contact Person
*
Your answer
Primary Contact
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(Name, Phone, Email)
Your answer
Secondary Contact
*
(Name, Phone, Email)
Your answer
Lead Teacher Summer Contact Information
*
(If same as above, type “same”)
Your answer
Alternate phone number(s)
*
(So we can contact you during the summer)
Your answer
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