Idaho State Museum Field Trip Request Form

Today's Date

Contact Name

School or Group Name

Grade Level(s)

Number of Students (Minimum 10)

Teachers and Paraprofessionals

Additional Adults

Phone Number

Billing Address

City

State

Zipcode

Day of Contact Name (If different from above)

Day of Contact Phone Number (if different from above)

Day of Email Address

Do your students require any accommodations?

In-Person Field Trip Options (select one):

Self-Guided Visit ($3 per student, 85 minutes of free exploration time) Summer Self-Guided Visit ($3 per student, 85 minutes of free exploration time) Guided Tour: Museum Highlights ($4 per student, 40 minutes of free exploration time) Guided Tour: Native American Stories ($4 per student, 40 minutes of free exploration time) Guided Tour: Innovation Idaho ($4 per student, 40 minutes of free exploration time) Guided Tour: Fighting for Rights ($4 per student, 40 minutes of free exploration time) Guided Tour + Hands-on Activity: Eye Spy Idaho ($5 per student, 10 minutes of free exploration time) Guided Tour + Hands-on Activity: Native American Traditional Ways of Knowing ($5 per student, 10 minutes of free exploration time) Guided Tour + Hands-on Activity: Drawn to Idaho ($5 per student, 10 minutes of free exploration time)

Virtual Field Trip Options:

Distance Discoveries: Gold Rush ($50 per class) Distance Discoveries: Oregon Trail ($50 per class) Distance Discoveries: Idaho’s Native Peoples ($50 per class) Add on Activity: Gold Panning ($3.00 per container, each container serves about 5 students, 1 week check out) Add on Activity: Paper Parfleche ($.50 per student) Add on Activity: Boat Building ($.50 per student) Add on Activity: Create Your Own State Seal ($.50 per student)

First Choice Date

Second Choice Date

Third Choice Date

Preferred Field Trip Time

Does your school qualify for Title 1 funding?

Yes No Unsure

Percent of students eligible for free or reduced-price lunch:

Are you A Home School Group?

Yes No

I have read the field trip policies and agree to all terms and conditions.

I agree