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Scheduling Worksheet Form

Use this online form to request a time for a student program at the North Carolina Museum of Natural Sciences.

The Museum's Scheduling Coordinator will contact you within three business days to confirm the availability of the requested class and to complete the scheduling process.

* Required fields marked with an asterisk

Contact Information

Name of group leader or teacher: *

Email Address*

Work Phone *

Home Phone *

Fax

School Name *

Type of School *

If other:

School Address *

City *

State *

Zip Code *

County *

Student Information

Grade level(s) of students: *

Number of classes: *

Number of students per class: *

Number of adult chaperones per class: *

Do you have students with special needs?

Yes No

If so, please elaborate:

Program Selection

Select your program topic below. Please see class descriptions for specifics on eligible ages and dates offered.

Date requested:

1st Choice *

2nd Choice *

3rd Choice *

Expected Arrival Time *

Expected Departure Time *

Additional information, questions or comments:

Additional Scheduling Information