2. Organization/ School Information

4. Organization or School Name*
6. Address*
8. City*
9. State*
10. Zip*
12. Group Leader(s)*
14. Email Address*
16. Work Phone
17. Other Phone

21. Requested Program Information

23. Program Type*
    -- Select One --On-site Program (at Watkins Nature Center)Away Program (at your site)Virtual Program
25. Program Title*

    Explore available programs through the links below! 

    • Curriculum Based Programs
    • Virtual School Program Flyer (PDF)
27. Other Requested Program (if not listed)
29. Please list any specific subjects or themes you would like us to touch on during your program
33. Program Date & Time (Option 1)*
    Program Date & Time (Option 1)

    Program Date & Time (Option 1)
34. Program Date & Time (Option 2)*
    Program Date & Time (Option 2)

    Program Date & Time (Option 2)
35. Program Date & Time (Option 3)*
    Program Date & Time (Option 3)

    Program Date & Time (Option 3)
37. Number of Attendees*
38. Number of Chaperones*
40. Group Age Range*
41. Grade(s)*
43. Special Accommodations Needed
Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit

* indicates a required field