School Family Nights
Application

Thank you for considering a School Family Night with the Science Museum. To begin the reservation process, please fill out our Application Form with as much information as possible. After submitting your request, one of our representatives will contact you to confirm your registration. You may also call (651) 221-9444 or (800) 221-9444.

Please note that this request does not guarantee a reservation. You will receive a confirmation invoice by email when you are confirmed.

School Info

School Name: *

School Address: *

City: *

State: * AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming

Zip: *

School Telephone Number: *

School District: *

Grades served at your school: *

Student Enrollment: *

Percent of Free and Reduced Lunch: *

Please help us stay green! By providing your contact information below, you help us prevent sending multiple mailings or emails about your reservation, museum events and invitations to educator previews.

Contact Info

Contact Name: *

Position: - None -ParentPTO MemberTeacherLiaisonPrincipalSpecialistOther

Please Specify:

Contact Home Address:

Contact Home City:

Contact Home State: AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming

Contact Home Zip:

Email: *

Daytime Phone Number: *

Preferred method of contact/communication: * - Select -PhoneEmail

Preferred time for us to call you:

Preferred Date(s)

1st Choice: * - Select -February 20, 2014February 27, 2014March 6, 2014March 13, 2014April 10, 2014April 24, 2014May 15, 2014May 22, 2014May 29, 2014

2nd Choice: * - Select -February 20, 2014February 27, 2014March 6, 2014March 13, 2014April 10, 2014April 24, 2014May 15, 2014May 22, 2014May 29, 2014

3rd Choice: * - Select -February 20, 2014February 27, 2014March 6, 2014March 13, 2014April 10, 2014April 24, 2014May 15, 2014May 22, 2014May 29, 2014

The Science Museum’s priority is to ensure our guests feel welcomed and accommodated. Upon acceptance to the School Family Nights program, a museum representative will contact you to discuss whether your group has any accessibility requests, including but not limited to, language interpretation. To the best of their ability, the museum staff will work with you to accommodate the diverse needs of your school community. Thank you.

Questions and Comments:

We will contact you on a rolling basis if your school has been selected for School Family Nights.