Virtual Field Trips Registration Form
To schedule a University of Nebraska State Museum Virtual Field Trip, please fill out the form below. You will be contacted within one week to schedule your virtual field trip program(s).

Questions concerning Virtual Field Trips can be directed to
elephant@unl.edu or 402-472-6302
Contact Name *
Your answer
Contact Email Address *
Your answer
Contact Phone Number *
This is the contact number where we can reach you during the VFT program in case of technical difficulties. Please list your classroom phone or cell phone number.
Your answer
Name of School or Library *
Your answer
Grade Level of Participants *
Your answer
# of Participants *
If you have multiple class periods for which you would like to schedule a VFT program, please list the number of students in each class period.
Your answer
School or Library Address *
Your answer
City, State, Zip *
Your answer
Is your class any of the following: *
Required
In which ESU is your school located?
Your answer
ESU Distance Learning Coordinator Name
Your answer
ESU Distance Learning Coordinator E-mail
Your answer
School Tech Coordinator Name
Your answer
School Tech Coordinator E-mail
Your answer
How would you like to connect? *
Contact your ESU distance learning coordinator or school tech person for this information if you aren’t sure.
Required
Virtual Field Trip
Please select which virtual field trip you would like your class or organization to participate in.
Preferred Dates *
Please list several preferred dates when you would be available to take your virtual field trip(s).
Your answer
Program Start Time(s) *
Please indicate when you would like your virtual field trip program to start. If you are scheduling a VFT program for multiple class periods, please list the time each class period starts.
Your answer
Description of Need
Thanks to a generous gift from the Roger's Foundation, Nebraska K-12 classrooms outside of Lincoln/Omaha can apply for scholarship funding to cover the Virtual Field Trip classroom fee. Please provide a description of need to be considered for a virtual field trip scholarship.
Your answer
How did you hear about our virtual field trip program? *
Please let us know how you learned about our virtual field trip program.
Required
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