School Registration Form

Optional Activities ($2.00/student additional fee) to be determined upon confirmation of date for your school visit.

The staff and volunteers at the Mound House – A Cultural & Environmental Learning Experience look forward to your school visit.

Please note: Teachers are invited to visit the Mound House prior to your school visit. Please bring a school id and the museum admission fee will be waived.

Name of School*
Address of School*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
School Phone Number*
Cell Phone Contact for day of Visit*
Date Requested 1st Choice*
MM slash DD slash YYYY
Date Requested 2nd Choice*
MM slash DD slash YYYY
Transportation*
- Bus
- Van
- Personal Vehicle
Grade of Student / Number of Students*
Time of Arrival*

: Hours

Minutes

AM/PM
Time of Departure*

: Hours

Minutes

AM/PM
Teacher(s) scheduling the school visit*
Your Email*

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School Registration Form

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