Reservations

Reservation Request Form

Please fill out this form to request your field trip at the Lancaster Science Factory. We will do our best to accommodate your needs and we will contact you to confirm your visit or to notify you about any potential conflicts.

Today’s Date______________________________

Teacher Requesting Field Trip ______________________________

Name of School_______________________________

Name of School District_______________________________

Grade Level of Students Attending ___________________________

Anticipated Number of Students ________

Anticipated Number of Chaperones

(please see suggested ratio on General Field Trip page)__________

Teacher Email Address___________________________________

Teacher Phone Number School____________________

Cell __________________

Date that you are requesting field trip ______________________________

Second Choice for date__________________________________

Anticipated time frame at the Lancaster Science Factory________________

Please check off the facilities that you intend to use at the Lancaster Science Factory

Classroom_____

Exhibit Floor_____

Do you have a prepared lesson plan, or activity for your class visit? (If so, may we see it in advance of your visit?)

____________________________________________________________

Please provide any additional information or questions to be addressed here.

_____________________________________________________________

_____________________________________________________________

_____________________________________________________________
 

Please mail this form to:

Lancaster Science Factory, Attn: Education Coordinator, 454 New Holland Ave., Lancaster, PA 17602