Submitted Date Submitted Date: Date Submitted Date: Time School Information School Name Street Address City State Zip Code School District We are a Title I School with 30% or more of our students receiving free or reduced lunch. Please send me additional information about how to apply for transportation reimbursement for up to $500 per bus and return tickets for students. Teacher Information Teacher Name Email Address Email Address Confirm email Primary Telephone Number Day of Visit Telephone Number Group Information Number of Students (Ages 4-18) Maximum of 75 students per request form. Number of Adults (19+) For every 5 students attending, groups will receive 1 free adult admission (ages 19+). Number of Additional Adults (19+) Additional Adults (19+): $21 Number of Personal Care Attendants, 1:1 student aides, or nurses Program Information Grade(s) Choose One Pre–K Superpower Senses K–2 Plant Power K–2 Tree-mendous Trees 3–5 Plant Power 3–5 Tree-Mendous Trees 3–5 Benefits of Nature 6–8 Plant Power 6–8 Finding Your Path 6–8 Benefits of Nature 9–12 Finding Your Path 9–12 Benefits of Nature K–12 Accessible Garden Discovery Program List any student accommodations we can provide for your group. Visit Information Before entering requested dates below, view current educator-guided field trip availability: Educator-Guided Field Trip Availability Calendar First Date Preference Program Time 10:30-11:30 am; Terrace Tent Reservation available 12:15-12:45 pm 12:00-1:00 pm; Terrace Tent Reservation available 11:30 am - 12:00 pm Second Date Preference Program Time 10:30-11:30 am; Terrace Tent Reservation available 12:15-12:45 pm 12:00-1:00 pm; Terrace Tent Reservation available 11:30 am - 12:00 pm Third Date Preference Program Time 10:30-11:30 am; Terrace Tent Reservation available 12:15-12:45 pm 12:00-1:00 pm; Terrace Tent Reservation available 11:30 am-12:00 pm Are you requesting more than one field trip? Please check if you have more than 75 students and are completing more than one field trip request form. If my 3 date preferences are not available for an educator-guided program, please reserve a self-guided field trip on one of the dates requested above. For Self-Guided Field Trip Details: Self-Guided Field Trips Arrival Time 10:00-10:30 AM 10:30-11:00 AM 11:00-11:30 AM Departure Time Please enter the time your group will depart Longwood Gardens. Number of Busses Dining Options Reserve the Terrace Tent for my group. I understand that there is no extra charge for the Terrace Tent and is limited to the times listed for my selected program time. Group will purchase food in the Café; seating available on a first come, first serve basis. Group will not be eating lunch in the Gardens. Additional Information Agreement I understand that a minimum of 15 students must be in attendance on the day of our visit to qualify for the free field trip program & admission. I will provide a final count of students, adults, and student support staff, 1:1 aides and/or school nurses to Longwood Gardens three weeks prior to my scheduled visit. I agree to act as lead teacher for this visit, responsible for all communication with Longwood Gardens and adults attending the trip. I understand that Longwood Gardens requires 1 adult for every 5 students provided in the final count. Additional adult admissions are $21 and must be paid in full for prior to arrival to the Gardens. I understand that cancellation of my program less than three weeks prior to my visit date may affect my school’s ability to receive free field trips in the future. I will provide feedback by completing the online survey after my visit. What code is in the image? Enter the characters shown in the image. Get new captcha!