School Programs Request Form

Thank you for your interest in a trip to our Museum/s! Please fill out the below inquiry form and we will contact you to schedule your trip. If you have any questions, or if you would like to talk to us about which program would best suit your needs, please contact Sara at 607-547-1461 or s.desalvatore@nysha.org.

Teacher/Contact Name:

Name of School or Organization:

Address of School or Organization:

City:

State:

Zip Code:

Phone:

Email:

Preferred Method of Contact:

What tour or workshop are you interested in?:

Please choose a preferred date for your visit:

Please choose an alternate date for your visit:

Please note that these dates are not guaranteed. School programs staff will be in touch to review your details and confirm a date.

Anticipated Arrival Time:

Anticipated Departure Time:

Please check if your group is interested in:

using our facilities for lunch

riding the Empire State Carousel at The Farmers’ Museum

shopping at Todd’s General Store at The Farmers’ Museum

shopping at the Museum Gift Shop

Type of Group:

School

Organization

Homeschool

Grade Level/s:

Number of Students:

Number of Chaperones:

Please note that we extend complimentary admission to teachers and adult chaperones at a 1:10 adult-to-student ratio. Additional adults will be charged a discounted adult admission rate. Please list the total number of adult chaperones on this form.

Number of One-on-One Aides:

School staff members that are necessary for the participation of a student (aides assigned to a specific student, required school nurse, or interpreter) are admitted without charge.

Please list any special needs or instructions: