* What district are you located in?

* What is the name of your school?

* School address and phone number:

* What grade level(s) are attending this field trip (if multiple teachers are submitting on this form, please make sure you're all from the same school):

* Include the name(s) and email(s) of any teacher(s) that are attending this field trip with their class:

* What show are you making this reservation for? Note: Spot where a show in the past was may be marked ----

* Please list the estimated number of students that are expected to attend this field trip, per class. If multiple classes are on this reservation form, please list each teacher and their correlating number of students separately. Example: Mrs. Jones: 24 students, Mr. Harold: 21 students..etc.

* How many chaperones will be attending with your class(es)? We understand that these numbers might fluctuate- please provide what you know and update our coordinator if/when this changes. One chaperone per every ten students get in free. For any additional chaperones (beyond the 1:10 ratio) we charge $5.00 per ticket. *Extra charge not applicable to FWPS*

(Skip question if part of FWPS) If a student cannot afford the 5 dollar ticket AND is currently receiving free and reduced lunch, they may qualify for a discounted ticket rate. Please provide the number of students who meet these criteria and need ticket fee assistance:

Are there any special needs requests that we need to be aware of? If yes, please provide additional information.

* Do you expect your school may need to apply for a bus grant? FYI: We will ask follow up questions when we contact you, to see if you qualify and to get more details.

(Skip questions if part of FWPS) How is your school/district paying for this? (Aka: Cash, check, bank/wire transfer, etc.)

How did you hear about our Arts 4 Youth program?

Do you have any additional questions or comments before you submit your reservation request?