Spring/Fall 2019 Artist Exchange Field Trip Request Form
Please fill this form out to request an AEX field trip. Our Manger of the Education and Public Programs Department will reach out to you shortly to begin booking. Gracias and Thank you!
Field Trip Coordinator's Full Name *
Your answer
Field Trip Coordinator's Position *
Your answer
Field Trip's Coordinator's Email *
Your answer
Will Field Trip Coordinator be present on the day of field trip?
Phone Number
Your answer
School Name *
Your answer
Complete School Address/City/State/Zip
Your answer
Parish
Your answer
Date Requested (First Choice) *
MM
/
DD
/
YYYY
Date Requested (Second Choice)
MM
/
DD
/
YYYY
Date Requested (Third Choice)
MM
/
DD
/
YYYY
Grade of Students *
Your answer
Number of Students *
Your answer
Special Needs? If yes, please detail
Your answer
ELL needs? If yes, detail out below. What is the native language and what is the level of English proficiency?
Your answer
Disciplines requested? 2 workshops for groups of 25 – 44 students or 3 workshops for groups of 35 – 50 students. No more than 3 workshops per day. *
Required
Comments/Questions
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Contemporary Arts Center. Report Abuse