Tideline Application
Email address *
Group name
Your answer
Contact Person
Your answer
Email
Your answer
Telephone (Day)
Your answer
Telephone (Evening)
Your answer
Address
Your answer
Has Clearwater worked with your organization before?
How long ago?
If this is your first Clearwater program, how did you hear about our organization?
Your answer
What is the grade level of your participants?
Your answer
How many participants?
Your answer
How many field programs?
Your answer
If you need more than one trip, how many students will attend each day?
Your answer
What are the names of the participating teachers (if you are the contact for more than one class)?
Your answer
Briefly describe the curriculum or project (if any) that you would like the Tideline program to support.
Your answer
Which elective would you like to have? (See program description on our website)
Your answer
Does your group have any special needs that need to be addressed (mobility issues, allergies, etc.)?
Your answer
Possible program dates?
Your answer
Impossible program dates?
Your answer
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of Hudson River Sloop Clearwater, Inc.. Report Abuse - Terms of Service - Additional Terms