Name of school/community group
Number of students in group
Teacher/Program Coordinator
Address
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
Contribute

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.

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