Name of school/community group
Number of students in group
Teacher/Program Coordinator
Date of Program Visit(s)
more items

Program fee is $10/student. Please note that if this is a multi-visit program, each day is $10/student (ex: a two visit program would be $20/student total).

Scholarship Amount Requested

Please share what you can about your group! We are committed to creating a diverse and inclusive organization, and this information helps us achieve this goal. All responses are confidential. Choose all that apply to the group.

Distinct Groups (check all that apply)
Race/Ethnicity (Select all that apply)