PROGRAM REQUEST FORM

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Please complete the following form to begin the process of confirming the Lemur Conservation Foundation's program: AM I LIKE A LEMUR? We will do our best to schedule your group, however; scheduling is based on the availability of staff and volunteers.

COST:
FREE, but donations are welcomed.

REQUEST TIMELINE:
Please understand when requesting this program, we will need at least one month notice. This is our most popular FREE program. Advanced notice increases your chances of successfully scheduling a program, but each request is considered based on the availability of staff and volunteers.

CONTACT:
Any additional questions should be directed to LCF's Education Manager at akoproject@lemurreserve.org.

Name of School or Organization *

Brief description of program participants (including age range or grade level) *

Name and title of person making request *

Your phone number *

Your email *

Preferred program date *

YYYY

Is there any flexibility with the selected date above? *

YES - Our schedule is flexible, and we can select an alternate date if necessary

NO - This is the only available date for our group

Alternate Date(s): Please list any alternative date information below in order for us to best help schedule your program.

Group Size *

1-3 classrooms (maximum 75 students)

4-6 classrooms (maximum 150 students)

7+ classrooms (more than 150 students)

Venue Name and Address *

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