2021-2022 Field Trip Interest Form

Step 1 of 3

Basic Information

Is your school a Title I designated school?(Required)

Additional funding and sponsorship for programming and/or transportation is available for Title I designated schools.

Yes

School Name(Required)

Primary Contact Name(Required)

First Last

Primary Contact School Role:(Required)

(e.g. classroom teacher, administrator, aide, etc.)

Primary Contact Email Address:(Required)

Primary Contact Phone Number:(Required)

Additional contact names:

Additional contact email addresses:

How did you hear about our field trip programs?

Class Information

Grade(s):(Required)

Number of classes (if more than one)(Required)

Please note MEarth is currently limiting programs to 30 students at a time. If you'd like to have multiple class visit, each class will have it's own field trip date and time.

Total number of students (approximately):(Required)

Total number of teachers available to attend the trip:

Will you or your school be willing to recruit additional parent volunteers?

Yes

Maybe

Please list the class's unit focus or any standards you'd like to be met through the field trip experience: