Please use this form to begin the process of scheduling an outreach program for your group. NOTE: This is an inquiry form only, to assist in the scheduling process. You will be contacted by one of our staff to set a date for the actual visit. Asterisked (*) fields are required.

*First name
*Last name
*Email
*Phone
*I prefer being contacted by: Phone           Email           Either
Fax
*Lead chaperone:
*Organization
Organization's address  
*Street
*City
(Preference will be given to organizations in Boston.)

*Zip code
*Number of children participating
*Grade levels of children (enter range when appropriate)
*Number of adults (1 chaperone required per 10 youth)
*Is your organization tax exempt?
Tax ID#
       
 
*Describe the mission of your organization and how this experience will benefit your group from an educational standpoint: