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Field Trip Request Form

This year's Riparian Preserve Field Trip programs are offered from October 22 through April 30, 2013. Thank you for your interest in our programming!

If you would like to request a field trip to the Riparian Preserve for your class, please complete the following:

*Indicates a REQUIRED field

Please complete the following:

*Field Trip Coordinator's Name:  

   Are you the.....  Teacher?  Parent?  Other?  

*Coordinator's E-mail:  

*Coordinator's Phone Number:  

*School/Group Name:  

*Address:  

*City:   *State:    *Zip:  

School/Group Phone Number/Extension:  

District/City:  

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PROGRAMS AND DATES: Please enter your preferred date of visit, and note any additional date preferences in the comments box. For larger groups visiting on multiple dates, please submit information for each group under separate dates below.

DATE FOR FIRST GROUP
*Enter date for 1st group:     MUST be in this format: mm/dd/yyyy

*Approx # of students visiting:     (Enter a number only!)

Grade level:   

Please select the number of topics you want:

3 Topics ($3 per student)   5 Topics ($6 per student)
Pre-School Program ($3 per student)

     Interact with wildlife (Add additional $3 per student, minimum of 30 students)

Topic(s) requested for this date:

(Choose up to three or five topics, depending on the pricing you selected above)
(PRE-SCHOOL PROGRAM: Please just select the first option and nothing else...)

PRESCHOOL PROGRAM: Dino Dig and Nature Walk Archeology: Simulated Dig Experience Avian Appreciation: A Bird's Life Beautiful Bugs: Specialized Life Forms Bunches of Birds: Diversity through Adaptations Ethnobotany: The Plants of Arizona’s Ancient Peoples Fossils: Lessons from the Past Groundwater: An Important Arizona Resource

Paleontology: Simulated Dinosaur Dig Experience Photosynthesis: Plants as Earth’s Food Factory Pollination: Getting to Know Flowers Respect the Insect: Appreciating Benefits Solar Energy: The World’s Power The Desert: A Web of Life The Shoreline: A Web of Life The Sun: Solar Viewings at the Observatory Tools for Observation: Lenses Change What We See Water Cycle: Water of Arizona’s Land and Sky

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DATE FOR SECOND GROUP
Enter date for 2nd group:     MUST be in this format: mm/dd/yyyy

Approx # of students visiting:     (Enter a number only!)

Grade level:   

Please select the number of topics you want:

3 Topics ($3 per student)    5 Topics ($6 per student)
Pre-School Program ($3 per student)

     Interact with wildlife (Add additional $3 per student, minimum of 30 students)

Topic(s) requested for this date:

(Choose up to three or five topics, depending on the pricing you selected above)
(PRE-SCHOOL PROGRAM: Please just select the first option and nothing else...)

PRESCHOOL PROGRAM: Dino Dig and Nature Walk Archeology: Simulated Dig Experience Avian Appreciation: A Bird's Life Beautiful Bugs: Specialized Life Forms Bunches of Birds: Diversity through Adaptations Ethnobotany: The Plants of Arizona’s Ancient Peoples Fossils: Lessons from the Past Groundwater: An Important Arizona Resource

Paleontology: Simulated Dinosaur Dig Experience Photosynthesis: Plants as Earth’s Food Factory Pollination: Getting to Know Flowers Respect the Insect: Appreciating Benefits Solar Energy: The World’s Power The Desert: A Web of Life The Shoreline: A Web of Life The Sun: Solar Viewings at the Observatory Tools for Observation: Lenses Change What We See Water Cycle: Water of Arizona’s Land and Sky

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DATE FOR THIRD GROUP
Enter date for 3rd group:     MUST be in this format: mm/dd/yyyy

Approx # of students visiting:     (Enter a number only!)

Grade level:   

Please select the number of topics you want:

3 Topics ($3 per student)    5 Topics ($6 per student)
Pre-School Program ($3 per student)

     Interact with wildlife (Add additional $3 per student, minimum of 30 students)

Topic(s) requested for this date:

(Choose up to three or five topics, depending on the pricing you selected above)
(PRE-SCHOOL PROGRAM: Please just select the first option and nothing else...)

PRESCHOOL PROGRAM: Dino Dig and Nature Walk Archeology: Simulated Dig Experience Avian Appreciation: A Bird's Life Beautiful Bugs: Specialized Life Forms Bunches of Birds: Diversity through Adaptations Ethnobotany: The Plants of Arizona’s Ancient Peoples Fossils: Lessons from the Past Groundwater: An Important Arizona Resource

Paleontology: Simulated Dinosaur Dig Experience Photosynthesis: Plants as Earth’s Food Factory Pollination: Getting to Know Flowers Respect the Insect: Appreciating Benefits Solar Energy: The World’s Power The Desert: A Web of Life The Shoreline: A Web of Life The Sun: Solar Viewings at the Observatory Tools for Observation: Lenses Change What We See Water Cycle: Water of Arizona’s Land and Sky

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Payment Method: Purchase Order   Cash or Check

     Please refer to the Schedule and Fees page to confirm start and end times.
     Any requested variance to the schedule must be noted in comments section.

Additional Comments: