Media Shakers (Grades 3-6) Field Trip Registration (1/15/2019)
Tuesday, January 15, 2019 11 AM- 2 PM
Family Name *
Your answer
Pathways IST *
Your answer
Contact Person *
Your answer
Daytime Phone *
Your answer
Email Address *
Your answer
Postal Mailing Address *
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Parent/Guardian will be: *
How many Pathways students are you registering for this field trip? *
Student cost is 40 EU (Educational Units) and will be deducted from student budgets. Grades 3-6 only.
Enter the full name, separated by commas, for each Pathways student registering for this field trip. *
Your answer
How many non-Pathways students are you registering for this field trip? *
Cost is $40 and must be paid by check. Instructions for payment will be emailed to you after you submit this form. Grades 3-6 only.
Enter the full name, separated by commas, for each non-Pathways student registering for this field trip.
Your answer
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