Please take a print out of this form
and mail the completed form to: NETXCM, P O
Box 994, Commerce, TX 75429, fax to 903-886-8088, or e-mail to
marypaz1@sbcglobal.net |
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Date Requested |
___________________________ (mm/dd/yyyy) |
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Time Requested |
______________________ |
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(Field trips can start
as early as 9 a.m. and are for two hours. Field trip including workshop is 2 1/2
hours.) |
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School/Group Name |
_________________________________ |
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Contact Name |
_________________________________ |
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Mailing Address |
_________________________________ |
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_________________________________ |
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Phone Number |
_________________________________ |
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E-Mail |
_________________________________ |
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Number of children |
_______ Age/Grade Level ______ |
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Number of adult helpers (Teachers, Aides) |
_______ |
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Alternate Contact Name and Phone # |
_________________________________ |
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"Discover!..." Workshop name: |
_________________________________ |
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How many children per workshop? |
___________________________ |
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| A museum representative will contact you to confirm
your request. |
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